The truth about the ACA.

[P.PattersonISwalkingthruthatdoor]

I got prescribed a drug that was going to be $694 for a MONTHLY supply. Then they give me a magic cars to reduce it to $10.

Eveything about what I just typed is so beyond ****ed up, people should be rioting in the streets to stop this system. Yet 99% of our society just shovels in another chalupa and races home to make sure their dvr is catching thr bachelor.

That's a cheap drug these days.

The scary part is that most of these monoclonal antibody drugs are essentially patent-proof (fantastic drugs, ftr). And now that's where all the Pharma companies are pouring their money. They'll be able to charged tens of thousands of dollars per administration for decades.

The ACA launched a pilot program to try to deal with that issue, but it'll take years to make a difference (if it even works).

 

[Cattoyz]

The ObamaCare exchange in Tennessee is "on the verge of collapse".

 

[Cattoyz]

I wonder if most folks know about the huge administrative burden ACA has put upon employers?

 

[nerdcat_rivals308595]

There is no hope for a system that in 2016 still requires the patient to fill out paper forms with the same information that is readily available if only the various systems were linked with each other.

 

[P.PattersonISwalkingthruthatdoor]

There is no hope for a system that in 2016 still requires the patient to fill out paper forms with the same information that is readily available if only the various systems were linked with each other.

or re-order tests that have already been run/entered in a different system.
or employ innumerable medical assistants and secretaries to track down said records.
or have entire divisions of hospitals dedicated solely to picking thru providers' documentation to see how much can be billed and what needs to be edited.

the list goes on and on.

 

[P.PattersonISwalkingthruthatdoor]

"They had one product [EpiPen], and they finally started making a little bit of money and everyone is going crazy over it....It's $300 and 90 percent of Americans are insured," Martin Shkreli told CBS News.

 

[mdlUK.1]

What the **** are you talking about? You've made an absurd leap from people WANTING entitlement reform also support Obama.

Did you eat paint chips as a kid?

You seem really slow on the uptake. You were whining about boomers getting the benefits they were promised after paying in to them their whole lives. I merely pointed out the hypocrisy of wanting to bring thousands of non citizens into an already stressed system.

And I have been for reform for years. Long before I retired infact. But dems fought against any idea of private accounts.

 

[P.PattersonISwalkingthruthatdoor]

nt

 

[Dennis Reynolds]

Simply Stating it could be misleading to a degree. The statement that we would get about 1/3rd more than we put in was highballing it. 2/3rds of 966 is 644 not 722.

OK, at the very least, try and get the math right. The numbers do in fact make sense. The statement was that you'd get 1/3 more than you put in. And $722 x 1.333 = $962. $722 isn't 2/3 of $966, because if something is 2/3 of anther number, then that would be a 50% increase. Math.

And, no I don't think we can really get mad at the Boomers for 1) being part of a huge generation and 2) playing by the rules the politicians set. But most people under 40 are pretty sure they will never see a dime of SS/Medicare despite paying in all our lives. Maybe they are wrong, hopefully they are wrong. I'd personally turn down SS right now if it simply meant I didn't have to pay any MORE into the system.

And ACA was all about redistribution and not taming HC costs. Hence all the extra BS tax increases associated with it. Guarantee you, if the Repubs ever are able to repeal it, they won't touch the tax increases.

Pti is basically right about the problems, but leaving one important one out - there are over a half dozen "hands" that touch the money in many HC/Pharma purchases. There are just too many hands out there all demanding a piece. For someone to simply fill a prescription, you need to see a 1) doctor, then head to the 2) pharmacy who gets their drugs from a 3) distributor who gets the drugs from a 4) Pharma company and has rates negotiated by a 5) PBM who serves an 6) Insurance company that is paid partially by your 7) company/gov so that 8) YOU can take your medication.

THAT is insane. To paraphrase Mitch Hedberg on donuts, "How about I give you the money and you give me the thyroid medication? End of transaction."

 

[mdlUK.1]

OK, at the very least, try and get the math right. The numbers do in fact make sense. The statement was that you'd get 1/3 more than you put in. And $722 x 1.333 = $962. $722 isn't 2/3 of $966, because if something is 2/3 of anther number, then that would be a 50% increase. Math.

And, no I don't think we can really get mad at the Boomers for 1) being part of a huge generation and 2) playing by the rules the politicians set. But most people under 40 are pretty sure they will never see a dime of SS/Medicare despite paying in all our lives. Maybe they are wrong, hopefully they are wrong. I'd personally turn down SS right now if it simply meant I didn't have to pay any MORE into the system.

And ACA was all about redistribution and not taming HC costs. Hence all the extra BS tax increases associated with it. Guarantee you, if the Repubs ever are able to repeal it, they won't touch the tax increases.

Pti is basically right about the problems, but leaving one important one out - there are over a half dozen "hands" that touch the money in many HC/Pharma purchases. There are just too many hands out there all demanding a piece. For someone to simply fill a prescription, you need to see a 1) doctor, then head to the 2) pharmacy who gets their drugs from a 3) distributor who gets the drugs from a 4) Pharma company and has rates negotiated by a 5) PBM who serves an 6) Insurance company that is paid partially by your 7) company/gov so that 8) YOU can take your medication.

THAT is insane. To paraphrase Mitch Hedberg on donuts, "How about I give you the money and you give me the thyroid medication? End of transaction."

Very sensible argument. They've been telling us SS was going broke long before I retired. And I would also have given up SS if I would have been able to invest the money I paid, myself.

And why are pols always trying to scare people about the money running out but never talk about cutting their benefits? And the always seem to have plenty of money to bring thousands of immigrants here.

 

[starchief]

or re-order tests that have already been run/entered in a different system.
or employ innumerable medical assistants and secretaries to track down said records.
or have entire divisions of hospitals dedicated solely to picking thru providers' documentation to see how much can be billed and what needs to be edited.

the list goes on and on.

I have a granddaughter who graduated medical billing school (top of her class). Her job was to over bill every possible dime they could get insurers to pay. If you can't pull that off you're out of a job. She lasted three months. When she saw what the job entailed she refused to participate in the scams. There went that career.

At my age, if I followed my doctor's advice, I would be in some doctor's office or testing facility monthly. "Send your patients to me and I'll send mine to you" seems to be the strategy. It is a mess if you play the game.

 

[P.PattersonISwalkingthruthatdoor]

I have a granddaughter who graduated medical billing school (top of her class). Her job was to over bill every possible dime they could get insurers to pay. If you can't pull that off you're out of a job. She lasted three months. When she saw what the job entailed she refused to participate in the scams. There went that career.

At my age, if I followed my doctor's advice, I would be in some doctor's office or testing facility monthly. "Send your patients to me and I'll send mine to you" seems to be the strategy. It is a mess if you play the game.

And the hospitals who don't play that game end up getting pushed out of the market.

 

[Ron Mehico]

This thread is depressing.

 

[starchief]

And the hospitals who don't play that game end up getting pushed out of the market.

I was in the Banner Healthcare system here in AZ. They are big out here. They were the absolute worst in shuffling patients around to their specialists in their system. My doctor tried her best to keep her patients out of the cycle. I'm sure they put a lot of pressure on her to get with the program.They finally fired her on the spot. Great doctor too. I was assigned four different doctors in two years. Two of them I never saw. Won't play the game - you're outta there. With Banner one day and gone the next. United Healthcare, my insurer, parted ways with Banner last year.

 

[P.PattersonISwalkingthruthatdoor]

I was in the Banner Healthcare system here in AZ. They are big out here. They were the absolute worst in shuffling patients around to their specialists in their system. My doctor tried her best to keep her patients out of the cycle. I'm sure they put a lot of pressure on her to get with the program.They finally fired her on the spot. Great doctor too. I was assigned four different doctors in two years. Two of them I never saw. Won't play the game - you're outta there. With Banner one day and gone the next. United Healthcare, my insurer, parted ways with Banner last year.

The other emerging battle is how health care systems (ex: St Joe's out of Lexington) are buying up tons of clinics and small community hospitals across large geographic areas. If an insurance company tries to negotiate prices too aggressively, a health care conglomerate will just tell them to GFY and they'll stop accepting that particular insurance, meaning that thousands of patients in those large geographic footprints either have to drive an hour or two to get to a provider or they have to crowd into the few clinics that still accept their insurance.

It's an arms race and the insurance companies aren't always the bad guys. Hospital conglomerates, physician networks, Pharma, etc are all fighting. Medicare and the private companies are left in the crossfire.

 

[roguemocha]

I'm pretty irate right now as I'm on vacation in Alaska and I need some eye drops. I only use these drops on occasion(maybe once a year) so I don't always have much on hand. These are just anti-inflammatory (simple prednisone/steroids), not numbing or narcotic eye drops. Well I need them now and my coverage is a FEDERAL program but I can't use it OUT OF STATE unless it's an emergency. On top of that my doctor can't call a prescription in to Alaska so I have to go see a doctor here. This condition I have is rare and your average family practice physician will never have heard of it. So, I'll have to tell HIM about the condition and how often I use the drops, etc. Then after paying him full price because my FEDERAL health insurance doesn't cover OUT OF STATE, on a visit in which he knew nothing about, just so he can write me a prescription so I can go pick up drops.

So I have to pay out of pocket, to tell a doctor what's wrong with me so he can say okay, "Tell me how to prescribe this". Then go wait at the pharmacy and pay them. Like Dennis said, just let me pay you for my meds, end of transaction.

Keep in mind, this insurance costs me, a healthy, 34 year old male that visits the MD maybe once a year, $268/month but I can only use it when I'm at home. It would honestly be cheaper for me not to have insurance and just pay everything out of pocket, besides obviously an emergency of some sort.

 

[Ahnan E. Muss]

I'm pretty irate right now as I'm on vacation in Alaska and I need some eye drops. I only use these drops on occasion(maybe once a year) so I don't always have much on hand. These are just anti-inflammatory (simple prednisone/steroids), not numbing or narcotic eye drops. ...This condition I have is rare and your average family practice physician will never have heard of it. So, I'll have to tell HIM about the condition and how often I use the drops, etc.

Uveitis/iritis?

 

[warrior-cat]

OK, at the very least, try and get the math right. The numbers do in fact make sense. The statement was that you'd get 1/3 more than you put in. And $722 x 1.333 = $962. $722 isn't 2/3 of $966, because if something is 2/3 of anther number, then that would be a 50% increase. Math.

And, no I don't think we can really get mad at the Boomers for 1) being part of a huge generation and 2) playing by the rules the politicians set. But most people under 40 are pretty sure they will never see a dime of SS/Medicare despite paying in all our lives. Maybe they are wrong, hopefully they are wrong. I'd personally turn down SS right now if it simply meant I didn't have to pay any MORE into the system.

And ACA was all about redistribution and not taming HC costs. Hence all the extra BS tax increases associated with it. Guarantee you, if the Repubs ever are able to repeal it, they won't touch the tax increases.

Pti is basically right about the problems, but leaving one important one out - there are over a half dozen "hands" that touch the money in many HC/Pharma purchases. There are just too many hands out there all demanding a piece. For someone to simply fill a prescription, you need to see a 1) doctor, then head to the 2) pharmacy who gets their drugs from a 3) distributor who gets the drugs from a 4) Pharma company and has rates negotiated by a 5) PBM who serves an 6) Insurance company that is paid partially by your 7) company/gov so that 8) YOU can take your medication.

THAT is insane. To paraphrase Mitch Hedberg on donuts, "How about I give you the money and you give me the thyroid medication? End of transaction."

I stand corrected. You are right, did not read into it clearly.

 

[starchief]

The other emerging battle is how health care systems (ex: St Joe's out of Lexington) are buying up tons of clinics and small community hospitals across large geographic areas. If an insurance company tries to negotiate prices too aggressively, a health care conglomerate will just tell them to GFY and they'll stop accepting that particular insurance, meaning that thousands of patients in those large geographic footprints either have to drive an hour or two to get to a provider or they have to crowd into the few clinics that still accept their insurance.

It's an arms race and the insurance companies aren't always the bad guys. Hospital conglomerates, physician networks, Pharma, etc are all fighting. Medicare and the private companies are left in the crossfire.

That s probably what happened in my situation.

 

[starchief]

The other emerging battle is how health care systems (ex: St Joe's out of Lexington) are buying up tons of clinics and small community hospitals across large geographic areas. If an insurance company tries to negotiate prices too aggressively, a health care conglomerate will just tell them to GFY and they'll stop accepting that particular insurance, meaning that thousands of patients in those large geographic footprints either have to drive an hour or two to get to a provider or they have to crowd into the few clinics that still accept their insurance.

It's an arms race and the insurance companies aren't always the bad guys. Hospital conglomerates, physician networks, Pharma, etc are all fighting. Medicare and the private companies are left in the crossfire.

The other emerging battle is how health care systems (ex: St Joe's out of Lexington) are buying up tons of clinics and small community hospitals across large geographic areas. If an insurance company tries to negotiate prices too aggressively, a health care conglomerate will just tell them to GFY and they'll stop accepting that particular insurance, meaning that thousands of patients in those large geographic footprints either have to drive an hour or two to get to a provider or they have to crowd into the few clinics that still accept their insurance.

It's an arms race and the insurance companies aren't always the bad guys. Hospital conglomerates, physician networks, Pharma, etc are all fighting. Medicare and the private companies are left in the crossfire.

I think that's what happened in my situation. Two huge conglomerates butted heads over prices and practices and just said "screw you." I suspect Banner was the loser though.

There is a hospital less than a half mile away but they don't accept my insurance (was built two years ago). I''ll bet 90% of its beds are empty. The one ten miles away closed after being open about a year. The only one in my plan is now 30 miles away.

 

[crazyqx83_rivals88013]

You seem really slow on the uptake. You were whining about boomers getting the benefits they were promised after paying in to them their whole lives. I merely pointed out the hypocrisy of wanting to bring thousands of non citizens into an already stressed system.

And I have been for reform for years. Long before I retired infact. But dems fought against any idea of private accounts.

I'm sorry you're under the delusion that the government is capable of promising you anything.

You're going to take everything the government "promised" you and blame the government for everything you view as a problem. If you can't see the irony there, you're beyond help. Typical boomer mentality.

 

[crazyqx83_rivals88013]

Because S

Very sensible argument. They've been telling us SS was going broke long before I retired. And I would also have given up SS if I would have been able to invest the money I paid, myself.

And why are pols always trying to scare people about the money running out but never talk about cutting their benefits? And the always seem to have plenty of money to bring thousands of immigrants here.

SS is a tax. Not a savings program.

 

[mdlUK.1]

SS is a tax. Not a savings program.

I never said it was a savings program. You are incapable of understanding anything. Does someone help you to remember to breathe?

 

[UKserialkiller]

Keep in mind, this insurance costs me, a healthy, 34 year old male.

I'm calling ******** on this.

 

[mashburned]

I have a granddaughter who graduated medical billing school (top of her class). Her job was to over bill every possible dime they could get insurers to pay. If you can't pull that off you're out of a job. She lasted three months. When she saw what the job entailed she refused to participate in the scams. There went that career.

At my age, if I followed my doctor's advice, I would be in some doctor's office or testing facility monthly. "Send your patients to me and I'll send mine to you" seems to be the strategy. It is a mess if you play the game.

Damn. Smh.

I appreciate what your g-daughter did. If more humans had souls it would help things a lot, I think.

 

[starchief]

I'm sorry you're under the delusion that the government is capable of promising you anything.

You're going to take everything the government "promised" you and blame the government for everything you view as a problem. If you can't see the irony there, you're beyond help. Typical boomer mentality.

 

[crazyqx83_rivals88013]

I'm pretty irate right now as I'm on vacation in Alaska and I need some eye drops. I only use these drops on occasion(maybe once a year) so I don't always have much on hand. These are just anti-inflammatory (simple prednisone/steroids), not numbing or narcotic eye drops. Well I need them now and my coverage is a FEDERAL program but I can't use it OUT OF STATE unless it's an emergency. On top of that my doctor can't call a prescription in to Alaska so I have to go see a doctor here. This condition I have is rare and your average family practice physician will never have heard of it. So, I'll have to tell HIM about the condition and how often I use the drops, etc. Then after paying him full price because my FEDERAL health insurance doesn't cover OUT OF STATE, on a visit in which he knew nothing about, just so he can write me a prescription so I can go pick up drops.

So I have to pay out of pocket, to tell a doctor what's wrong with me so he can say okay, "Tell me how to prescribe this". Then go wait at the pharmacy and pay them. Like Dennis said, just let me pay you for my meds, end of transaction.

Keep in mind, this insurance costs me, a healthy, 34 year old male that visits the MD maybe once a year, $268/month but I can only use it when I'm at home. It would honestly be cheaper for me not to have insurance and just pay everything out of pocket, besides obviously an emergency of some sort.

But you're making bank as a day bartender, so... #YOLO, amirite?

 

[crazyqx83_rivals88013]

I never said it was a savings program. You are incapable of understanding anything. Does someone help you to remember to breathe?

You've REPEATEDLY said "I paid into it." You didn't "pay into" jack, you were taxed.

Are you incapable of understanding the words you are typing?

 

[mdlUK.1]

You've REPEATEDLY said "I paid into it." You didn't "pay into" jack, you were taxed.

Are you incapable of understanding the words you are typing?

Lol. Are you really that stupid? I picture you as a Walmart greeter but I may have too high of an opinion of you.

 

[crazyqx83_rivals88013]

Lol. Are you really that stupid? I picture you as a Walmart greeter but I may have too high of an opinion of you.

I'm an architect. Good guess, though.

 

[mdlUK.1]

I'm an architect. Good guess, though.

Then you must make decent money. Why all the crying?

Unless you're George Costanza?

 

[crazyqx83_rivals88013]

Then you must make decent money. Why all the crying?

Unless you're George Costanza?

At what income level would you enjoy paying $6k in a 4 month period in medical bills while you watched boomers with 7 figure net worth pay minimal premiums for sweet *** coverage policies?

 

[mdlUK.1]

At what income level would you enjoy paying $6k in a 4 month period in medical bills while you watched boomers with 7 figure net worth pay minimal premiums for sweet *** coverage policies?

Jealousy is an ugly thing. You would think someone with your education would be above that but I guess not.

Did they teach you at any point about honor or commitment? You seem to have neither.

 

[crazyqx83_rivals88013]

Jealousy is an ugly thing. You would think someone with your education would be above that but I guess not.

Did they teach you at any point about honor or commitment? You seem to have neither.

Is that your way of justifying your sweet *** entitlements while you bankrupt our country?

Nice buzzwords though...

 

[mdlUK.1]

Is that your way of justifying your sweet *** entitlements while you bankrupt our country?

Nice buzzwords though...

Lol... So all seniors have 7 figure net worths? How the eff did you make it through college?

 

[crazyqx83_rivals88013]

Lol... So all seniors have 7 figure net worths? How the eff did you make it through college?

Do you even know what a ******* entitlement is?

How are you even able to access the internet? Intelligence wise...

 

[mdlUK.1]

Do you even know what a ****ing entitlement is?

How are you even able to access the internet? Intelligence wise...

Do you know what honoring a commitment means? No honor in your generation!

 

[crazyqx83_rivals88013]

Do you know what honoring a commitment means? No honor in your generation!

Like I said... You're going to get what your PREDECESSORS "promised" you and **** it if it ruins everyone after you and the entire country in the process. Thanks for the nearly $20T in debt with that ******** mentality, assbag.

Real responsibility is just accepting that this crap was a tax and "forfeiting" the nearly 20 years I've paid in if they would just eliminate the damned program that was designed to pay out at an age that was AFTER the average life expectancy.

 

[mdlUK.1]

Like I said... You're going to get what your PREDECESSORS "promised" you and **** it if it ruins everyone after you and the entire country in the process. Thanks for the nearly $20T in debt with that ******** mentality, assbag.

Real responsibility is just accepting that this crap was a tax and "forfeiting" the nearly 20 years I've paid in if they would just eliminate the damned program that was designed to pay out at an age that was AFTER the average life expectancy.

Lol, so now I'm responsible for the 20 trillion debt, 12 of which happened the last 8 years?

No way you're anything but a Walmart greeter.

 

[Cattoyz]

You've REPEATEDLY said "I paid into it." You didn't "pay into" jack, you were taxed.

Are you incapable of understanding the words you are typing?

Actually, one does "pay into" the social security fund. It's just that the "payments" are required and collected as a mandatory payroll tax. IIRC, back in the day, Social Security was referred to as "Social Security insurance". I believe that's because SS was set up on a basis similar to private insurance where one pays premiums to a private insurance company, and, may, or may not , file a claim.