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Post by Deleted on Jun 10, 2017 9:20:48 GMT -6
On that note though, I don't know how to bridge the gap in ideology for people that don't view healthcare as a right. I just....I don't know if we are ever going to agree on policy if we don't have common ground on that point.
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kitchen
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Post by kitchen on Jun 10, 2017 9:23:36 GMT -6
On that note though, I don't know how to bridge the gap in ideology for people that don't view healthcare as a right. I just....I don't know if we are ever going to agree on policy if we don't have common ground on that point. Yes. This is a huge problem. I can't reconcile it at all. I think the avenue of "we are already providing care for some of these people, just in an incredibly inefficient way?" That's probably too complex of an argument though. Ugh.
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Post by Deleted on Jun 10, 2017 9:28:38 GMT -6
Before the ACA passed, my employer-based health insurance was just as outrageously expensive, but the list of things not covered was wild. I remember seeing that they would only cover one pregnancy, for the lifetime of the policy, in maternity coverage and wondering, "how the hell is that legal?!" Then the ACA passed and it wasn't anymore. I just think people who blame all the prices on Obamacare don't remember what things were like before. Yes. It's a bit of revisionist history. The high deductible plans and double digit yearly increases in premiums were trends well before the ACA. And they could take all that money and deny coverage so much easier
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Post by Deleted on Jun 10, 2017 9:45:31 GMT -6
@heartbot I just can't. So much stupidity.
But, then they can talk for hours about their right to own a gun. Cuz priorities, man.
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dc2london
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Post by dc2london on Jun 10, 2017 10:08:03 GMT -6
It is what it is. We've discussed many times having him become a fed again for the insurance but ...under Trump.....
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Post by Deleted on Jun 10, 2017 11:53:43 GMT -6
So does anyone pay the $200 for ibuprofen? People without any insurance?
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Post by Deleted on Jun 10, 2017 12:05:07 GMT -6
I took the job I'm in now mainly for the benefits. I'm supremely lucky that I was able to find a position in my field with the benefits I now have.
I have some coworkers who have been there forever and never worked in a museum outside of the university setting and they have no fucking clue how lucky they are. I have to bite my tongue often.
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Post by Deleted on Jun 10, 2017 12:31:38 GMT -6
So does anyone pay the $200 for ibuprofen? People without any insurance? It gets paid by insurance companies that pay a percentage of charges, but MOST insurance companies pay a flat rate per day for Inaptient or a case rate for an OUtpatient surgery. So for that, it just depends on the contract and situation. But not the full amount. Uninsured patients get an automatic discount at almost every facility I've worked at (in the last 5-10 years), so right off the bat they get 50% off their charges. (% depends on the policy). Then they go through the financial assistance program and if they qualify for charity care (based on income and assets), they get a partial or full write off of their charges. So, maybe in a few situations we get paid for that, but not the full amount.
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Post by Deleted on Jun 10, 2017 12:32:17 GMT -6
It is what it is. We've discussed many times having him become a fed again for the insurance but ...under Trump..... That loyalty pledge. 😳
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Post by Deleted on Jun 10, 2017 12:49:57 GMT -6
Trump's doing a fundraiser for McArthur (the Rep who reanimated the AHCA) this weekend.
So fucking sickening that he sold out millions of people's health for campaign funds.
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Post by morecoffeeplease on Jun 10, 2017 13:33:55 GMT -6
I heard an interview with Tom Periello a few weeks ago, and he said something along the lines of "I lost my House seat after voting for the ACA. I am frequently asked if I regret that vote, but I would absolutely do it again. Because health care is more important than my House seat." The fact that the majority of the GOP feels differently is really disheartening. Like did Paul Ryanhave them check their consciences at the door?
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Post by bunnyfungo on Jun 10, 2017 13:42:22 GMT -6
Can anyone explain to me how other countries handle health care in regards to it being tied to employment? I think crimsonandclover said that where she is (somewhere in the EU?) that they pay 8% and the employer pays in an additional 8%. I understand the argument of having employers subsidizing some of the cost. But from a practical standpoint, it makes zero sense to me to have your health insurance tied to your employment. Wherein, depending on whether you have a good or bad employer determines whether you have good or bad or affordable coverage. Not to mention the logistical nightmare of what happens to you if you become too sick to work and lose your job/insurance. I'm wondering if I'm missing something that other countries have figured out. I keep thinking about a coworker at my last job. She was in the 90 day period before she qualified for insurance. She went into anaphylactic shock and almost died. So even though she had a full time job, that offered benefits, she wasn't currently covered. The medical bills were outrageous and she spent a lot of time trying to negotiate with the hospital, and still had to pay a ridiculous amount. I felt so so bad for her.
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Post by crimsonandclover on Jun 10, 2017 13:46:31 GMT -6
bunnyfungo , I do live in the EU, but our insurance is not tied to our employer in the same sense that it is in the US. All employers here pay 8% for all employees. That's a country-wide law, not a company-by-company policy. If I am fired, I keep my insurance, and for the time period that I'm unemployed, I get insurance for free (because I pay 8% of my income, and 8% of 0 is 0). If I get another job with a different company, then I start paying my 8% again and my employer starts paying 8% - to the same health insurance provider I've been with the entire time (Unless I want to switch. I can do that if I want, but I don't have to ever.). The sucky part is that if you're self-employed you have to pay 16% because you're both the employer and the employee. ETA: My first sentence could be misleading. This is not the case for all EU countries, only for mine. I have only vague ideas of how it works in other EU countries.
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Post by bunnyfungo on Jun 10, 2017 13:48:44 GMT -6
bunnyfungo, I do live in the EU, but our insurance is not tied to our employer in the same sense that it is in the US. All employers here pay 8% for all employees. That's a country-wide law, not a company-by-company policy. If I am fired, I keep my insurance, and for the time period that I'm unemployed, I get insurance for free (because I pay 8% of my income, and 8% of 0 is 0). If I get another job with a different company, then I start paying my 8% again and my employer starts paying 8% - to the same health insurance provider I've been with the entire time (Unless I want to switch. I can do that if I want, but I don't have to ever.). The sucky part is that if you're self-employed you have to pay 16% because you're both the employer and the employee. Okay thanks. That makes sense. And I like that a lot better. Does anyone know what most employers pay on average here in the US? I'm wondering if an across the board percentage like that would save them money or not. Since, ya know, Washington seems to care more about business' best interests than their constituent's.
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Post by blurnette989 on Jun 10, 2017 13:51:24 GMT -6
Another thought: I worked in HR consulting when the ACA was passed. I know that the healthcare consultants absolutely billed it to their clients as an opportunity to make changes that would increase employee cost sharing and blame it on Obama. Some of the shit employers did was pre-emptive "well, obamacare!!!" either as a preventive measure under the assumption that costs would go up more, or just because they're assholes. #blameobama extends outside of government. This happened to mh. He worked in a small company. They blamed the ACA on rising premiums and made employees pay an increased amount towards premiums. MH found the spreadsheet with the actual increases and it was a fraction of what they increased the premiums by. They simply lied.
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Post by crimsonandclover on Jun 10, 2017 13:52:50 GMT -6
bunnyfungo , I do live in the EU, but our insurance is not tied to our employer in the same sense that it is in the US. All employers here pay 8% for all employees. That's a country-wide law, not a company-by-company policy. If I am fired, I keep my insurance, and for the time period that I'm unemployed, I get insurance for free (because I pay 8% of my income, and 8% of 0 is 0). If I get another job with a different company, then I start paying my 8% again and my employer starts paying 8% - to the same health insurance provider I've been with the entire time (Unless I want to switch. I can do that if I want, but I don't have to ever.). The sucky part is that if you're self-employed you have to pay 16% because you're both the employer and the employee. Okay thanks. That makes sense. And I like that a lot better. Does anyone know what most employers pay on average here in the US? I'm wondering if an across the board percentage like that would save them money or not. Since, ya know, Washington seems to care more about business' best interests than their constituent's. To be more accurate you'd have to factor in whether set employer contributions would result in more/better insurance with preventive care, which could mean employees having fewer sick days, resulting in higher productivity. But even though that's more accurate, it's not a nice, clean number that would make for a good soundbite, so it probably wouldn't help.
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athn64
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Post by athn64 on Jun 10, 2017 13:54:28 GMT -6
Another thought: I worked in HR consulting when the ACA was passed. I know that the healthcare consultants absolutely billed it to their clients as an opportunity to make changes that would increase employee cost sharing and blame it on Obama. Some of the shit employers did was pre-emptive "well, obamacare!!!" either as a preventive measure under the assumption that costs would go up more, or just because they're assholes. #blameobama extends outside of government. This happened to mh. He worked in a small company. They blamed the ACA on rising premiums and made employees pay an increased amount towards premiums. MH found the spreadsheet with the actual increases and it was a fraction of what they increased the premiums by. They simply lied. My brother got screwed because his insurance used it as an excuse to bill him more for a previous surgery. I've told him it's the company's fault but he's stubborn and won't listen to me.
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Post by blurnette989 on Jun 10, 2017 14:25:50 GMT -6
bunnyfungo in Portugal the majority of people are covered by the national system which is funded by individual taxes. But interestingly certain industries have their own national subsystems. If you work for that employer you must use their insurance system. It makes sense for some groups, military, public servants, buy the employees of Caixa Geral (a bank) have a subsystem too. It's very interesting and confusing. Also goes to show, it can vary widely in each EU country.
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Post by Uncaripswife on Jun 10, 2017 14:57:14 GMT -6
Holy cow, dc2london. That is a lot. I thought we paid more compared to Americans, but it's less than 50% of just your premiums. O.O Do you know if that's standard in your DH's line of work? Or are their factors that cause your premiums/deductibles to be higher than a similar family with 3 kids? I work in employee benefits. It's not at all unusual.
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Post by Uncaripswife on Jun 10, 2017 14:58:08 GMT -6
Another thought: I worked in HR consulting when the ACA was passed. I know that the healthcare consultants absolutely billed it to their clients as an opportunity to make changes that would increase employee cost sharing and blame it on Obama. Some of the shit employers did was pre-emptive "well, obamacare!!!" either as a preventive measure under the assumption that costs would go up more, or just because they're assholes. #blameobama extends outside of government. Yup.
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Post by Uncaripswife on Jun 10, 2017 15:01:44 GMT -6
+1 to what dc2london said. The healthcare system in America is inhumane and flawed on so many levels - I can't really even discuss it with many people without banging my head against a wall. I'm American (with a degree in Insurance and Risk Management) - and I will say this - so many Americans I have spoken with about the U.S. healthcare system are incredibly arrogant and ignorant on this topic. It's astounding. There is zero willingness to educate themselves on why virtually every other single developed country in the world has adopted a single payer system. The insistence that the U.S. can't learn from what other countries have figured out decades ago is really disheartening. When I try to have a calm and rational conversation with anti-ACA people about this, they tend to start lashing out at me personally and revert to off-topic rhetoric/talking points. This typically happens once they realize they are out of their depth on the subject or feel they are "losing" the argument. Older conservatives and Trump supporters in particular will spew their hatred for ACA and universal healthcare...but then in the same breath say they love their Medicare, and how dare you even suggest we do away with it. Head --> Desk. Medicare IS a single-payer microsystem. If Medicare covered ALL Americans at the macro level, the U.S. Government would have much more leverage in negotiating reimbursements with healthcare providers, which would significantly lower/control healthcare costs and increase administrative efficiencies throughout the entire U.S. health system. Plus - as @juliagulia has already explained - people with insurance are ALREADY subsidizing the costs of the uninsured/underinsured, via higher premiums and higher payments to healthcare providers to make up for the deficit from those who cannot pay or are bankrupted by their healthcare bills. You'd think these arguments would appeal to a supposedly fiscally-focused demographic, but no. Rush Limbaugh and Breitbart said Universal Healthcare will destroy America, so I'm going to stick with what they told me. On a moral/ethical level, the total and complete lack of empathy for people with who have to choose between groceries and healthcare/medication for themselves and their children really sickens me. I live in Asia, in a country that is not first world. The healthcare here is world class and affordable. I actually receive better care here than I do in America, at a fraction of the cost. The healthcare industry doesn't have to be the way it is in America - but unless a big chunk of the population actually realizes how the rest of the world works and realizes how truly broken/inefficient the U.S. system is, I unfortunately don't see this problem being resolved anytime soon. It really is a willful ignorance. Yes. ::insert clapping audience gif::
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Post by Uncaripswife on Jun 10, 2017 15:16:36 GMT -6
bunnyfungo this is a summary of a survey conducted by the Kaiser Family Foundation, regarding costs in employer sponsored health coverage. "In 2016, the average annual premiums for employer-sponsored health insurance are $6,435 for single coverage and $18,142 for family coverage. The average family premium rose 3% over the 2015 average premium while the increase in the premium for single coverage was not statistically significant. The average premium for family coverage is lower for covered workers in small firms (3-199 workers) than for workers in large firms (200 or more workers) ($17,546 vs. $18,395). Workers’ wages increased 2.5% and inflation increased 1.1% over the period.2 Premiums for family coverage have increased 20% since 2011 and 58% since 2006. Average premiums for high-deductible health plans with a savings option (HDHP/SOs) are considerably lower than the overall average for all plan types for both single and family coverage, at $5,762 and $16,737 respectively (Exhibit A). These premiums do not include any employer contributions to workers’ health savings accounts or health reimbursement arrangements. As discussed below, the share of covered workers with HDHP/SOs has grown eight percentage points over the last two years; this change in enrollment has reduced the growth in single and family premiums by roughly a half percentage point each of the last two years." Source: www.kff.org/health-costs/report/2016-employer-health-benefits-survey/
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cnf
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Post by cnf on Jun 10, 2017 15:23:26 GMT -6
Holy shit dc2london, that is so expensive! That plan would absolutely bankrupt my family. We could not afford that and we're a pretty solid middle class income family.
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Minerva
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Post by Minerva on Jun 10, 2017 16:42:07 GMT -6
dc2london, we're in the opposite boat. DH just got a non-fed job offer. We're trying to figure out what sort of raise he would need to negotiate to offset the loss in federal benefits. It's going to be a fair amount. It sucks having health insurance tied to employment. It really limits changing jobs and entrepreneurship.
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Post by blurnette989 on Jun 10, 2017 17:42:29 GMT -6
::snip:: It sucks having health insurance tied to employment. It really limits changing jobs and entrepreneurship. So much this. People really seem to discount this, but especially in times of layoffs and depressed wages, people don't voluntarily take risks in the labor market because of benefits.
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Post by Deleted on Jun 10, 2017 19:10:31 GMT -6
Health insurance tied to employment just doesn't make sense anymore. The economy is so different. People don't go to work for one company and stay there for 45 years anymore. Yet, here we are.
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Taitai
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Post by Taitai on Jun 10, 2017 19:40:00 GMT -6
bunnyfungo In the country where I live, the government manages a basic, universal healthcare system which provides care to all citizens (regardless of whether you are emoloyed) for a cost of $1 per visit/hospitalization (the country where I live is not first world, so $1 here is probably equivalent to more like $5 in the U.S. for a local low income person). On top of that, all employees are required to contribute a small amount (about 3% of their monthly salary) to a personal healthcare savings account, which is run and managed my the government. The employer also matches the employee contribution each month. Employees can use the funds from their personal healthcare account to pay for "higher" levels of care, which are not automatically covered by the national-run, universal healthcare system. The $1 universal healthcare plan and the personal healthcare accounts can only be used at public hospitals, which are run and managed by the ministry of health. In addition to contributing to the personal healthcare accounts, some employers (often companies which employ highly skilled workers such as accountants or lawyers) will offer supplemental health insurance plans to their employees, which the employees can use at private hospitals. Private hospitals have quicker wait times, nicer facilities, and will perform elective surgeries that the public ones will not. The private hospitals are comparable or better than U.S. hospitals, and they are also affordable for middle-income and upper income citizens of the country where I live. A visit to the doctor at a fancy private hospital (where it looks like a spa inside and there are often musicians playing relaxing live music) costs about $20 - $30. Lab work, ultrasounds, and other diagnostic work are a fraction of the cost of U.S. prices ($40-60 for a diagnostic ultrasound, $9 for full panel blood work). I stress, this is before insurance pays anything. If you have insurance that is accepted at a private hospital, then the costs are obviously much lower or free. An example of how the public $1 universal works is when one of my employees had to have major abdominal surgery two years ago. She went to the public hospital and the surgeon performed her surgery for $1, which also covered the hospitalization of 1 week and all medicine/nursing charges. As she had a personal healthcare account (because she is employed), she was able to use some of those funds to upgrade to a more private room and get her name on the surgery schedule quicker. The public hospital would have given her the surgery immediately if it was life threatening, but since it wasn't, she might have waited 4-6 months for the surgery. Instead, with funds from her healthcare account, she only had to wait a month to get the surgery. So, the system is very different than the U.S. and has its own quirks, but I think it is a very good system -especially for a country that is not first world. The personal healthcare accounts motivate people to work to obtain better care. However, there is always a basic healthcare safety net if you need it - and it just costs $1. Want an annual physical? $1. Don't have a job and need to have a baby? $1 total cost to have the baby at the hospital (sorry, no epidural though, as that is elective). Don't have a job, but you were hit by a bus? They will not let you die on the street - your life will be saved and you will be hospitalized until you are stable enough to be released. $1. If you need additional surgeries due to the bus accident that only improve the quality of life (versus save it), well....you'll either have to wait a long time or save up money to go to a private hospital. But you won't die, and you will receive decent health care. If a developing country can figure out how to give healthcare to all of its citizens - many of whom are very poor and do not pay any taxes, there is absolutely no reason why an incredibly rich country like the U.S. (the leader of the free world) can't do it.
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Post by oreobitsy on Jun 10, 2017 23:30:47 GMT -6
Ben Wikler had a good twitter thread on how to create some momentum/action on the health care bill in the next three weeks. (I'll figure out how to link, but tonight is late).
Thank you all so much for your insightful, intelligent explanations of so many elements of health care. I appreciate it so much. I understand the bigger picture a little better.
I, like many of you, are tied to the benefits our employer offers. It affects us because we know we have at least two more years of treatment for our child, but can't guarantee the employment situation will stay the same. Even thinking of switching jobs means we have to consider when our insurance/out-of-pocket max restarts because we don't want to have to pay two maximums in one year.
Also, @juliaguila , your clothing store example is spot-on. As a consumer, it is impossible for me to figure what I actually owe versus what has been negotiated with insurance. I have made payments according to the bills sent to me, but then received reimbursements because due to overpay. I could go on and on with examples. It's a terrible system, stressful for anyone but especially for those that have to consider coping with medical issues too.
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Post by oreobitsy on Jun 10, 2017 23:32:33 GMT -6
Oops double post. Hit my two margarita limit at a pool party last night and got all excited about health care.
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Taitai
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Post by Taitai on Jun 11, 2017 1:18:03 GMT -6
For anyone who is passionate about this topic and wants to gain additional understanding about the unique flaws/challenges of the U.S. healthcare system, I highly recommend an award-winning feature written by Steven Brill for Time Magazine back in 2013. Warning, it's looooong...but it is so in-depth, balanced, well-written, supported by figures/statistics, and informative. It also contains very good action points at the end. I always share it with family and friends who seem open or interested in genuinely learning about why they should or should not support healthcare reform in the U.S. ACA is a step in the right direction, but in my opinion, single-payer, universal healthcare is really the only way to reign in the unsustainable rising costs we see in the U.S. healthcare system - which in turn is making insurance virtually unaffordable for so many people/employers. If nothing more than an interesting read, it could give reasonable people more confidence when we discuss/debate these issues with those who may disagree with us - or with those who are simply too uninformed to come to their own conclusion on the issue (and then default to falling in line with whatever their political party tells them is "correct"). Here is a link: www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf Edited: Ugh...for some reason the hyperlink isn't working. If you highlight/copy/paste the URL into your browser, it should work and come up as a PDF.
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