I could easily pay 10% of my income in medical co-payments

[mdmc]

if I had 10% to part with.
I go without medical treatment because I cannot part with 10% of my income.
There ain't a thing in this bill that will help me is there?
I will need to be disabled by my illness before I see a benefit in the HCR bill.

[jaxx]

1. Payments will be subsidized Jan.1, 2014.

I know that doesn't help today, but it will. Hang in there.

[mdmc]

3. I can hang in there until then.. God willing

thanks for the info..
a bright spot in a bleak day..
peace and God bless.

[jaxx]

5. Good for you.

I'm trying to hang in there too and we'll make it, I'm sure. :hi:

[mdmc]

6. Peace and God Bless

:pals:

[HuckleB]

19. That's the hope.

GOPers could regain power and repeal it long before then.

We're all *&%$#@ until then, and maybe long after.

But, well, take care.

:hi:

[another saigon]

33. IF

he qualifies. If. One of those convenient conditions for the FOR PROFITS.

[Recursion]

36. How do you know his insurance is for-profit?

About 40% of private policies are through non-profit insurance companies.

[another saigon]

37. just a hunch

http://trueslant.com/rickungar/2010/02/16/private-health-insurance-industry-in-%E2%80%98death-spiral%E2%80%99/

-snip-

Despite the record profits earned last year by health insurance companies, Anthem Blue Cross in California lost money on their individual coverage plan. And their story is not unique. Health insurance companies throughout the country are finding their individual policy business to be unsustainable. These losses are the direct result of too many healthy customers being forced to drop out of the insurance pool due to their inability to cover the costs of buying the insurance. Their exit leaves an imbalance in the ratio of healthy to unhealthy in the pool – and that inevitably leads to losses.

How does an insurance company solve this problem? They boost prices high enough to force more of the sick out of the pool in an effort to restore the balance.

Health insurance companies would love nothing more than the opportunity to get out of the individual insurance market. But they dare not do so as the political fallout could have a negative impact on the part of their business that remains profitable – group health policies for employees.


-snip-


If you recall, both the Senate and House reform bills specifically prohibited those who receive health care benefits at work to participate in a public insurance plan. They did this to protect the insurance companies from losing the part of their business that remains profitable.

[Recursion]

38. What I'm not seeing is a difference in non-profit and for-profit plans

The individual market is expensive for everyone. People who don't get insurance through work, and aren't sick, don't seem to be buying insurance, because they see it's not a good financial deal 99% of the time (the problem is you don't know if you're one of the 1% before it's too late). The exchange system effectively gets rid of that market, but only with a mandate.

[TheKentuckian]

41. To keep them at 10% not to relieve not having the 10%

Of course if the subsidies can't make up the difference than you can resume having nothing and don't even have to face any penalties.

[eridani]

64. Just premiums--not deductibles or copays n/t

[pnwmom]

2. And if you get in a car accident tomorrow and break your back,

will you still go without treatment?

[mdmc]

4. depends if my car insurance would cover treatment

I still get treatment for my illness, I just cannot afford all the treatments that are prescribed to me. If I could afford them I would be good to go.

So if a broken back would cost a couple grand, I would hope they would fix me up and send me into bankruptcy. Unless car insurance would pay for it.

[pnwmom]

14. You have no idea. My daughter broke the tip of her finger

using a weight machine and the emergency room and doctor costs were over $5,000.

[Dappleganger]

46. Really?

Wow.

:hug:

[Fumesucker]

7. If you don't have the money you don't have the money..

I have no idea why some people seem to find that hard to understand.

People die every day in this country because they cannot afford medical treatment, often very basic medical treatment.

[mdmc]

8. I replied that the ER would probably fix me up, then I would

go into bankruptcy (unless car insurance paid for treatment).. Isn't that how its done for the lucky (the get fixed up and go bankrupt)?

[Fumesucker]

9. The ER will stabilize you..

They damn sure won't provide everything you're almost certain to need in the case of a broken back.

I hope things go well for you.

[mjane]

32. I'm really surprised how many people give their real name and info

when they go to the ER *and* they don't have insurance, etc.

It's the honest thing to do, of course, but...

[pitohui]

67. you're unconscious they search you

i know ONE person who got away w/ what you're suggesting when she was unconscious but she was long term homeless and had NO identifying material on her at all, she already had nothing

[pnwmom]

16. You can't go into bankruptcy every time you have a medical crisis.

[Recursion]

24. Well, unfortunately people can and do NT

[pnwmom]

30. Current bankruptcy law limits repeat filings.

http://ezinearticles.com/?Automatic-Stay-in-Bankruptcy---How-Do-Repeat-Bankruptcy-Filings-Affect-the-Case?&id=3689015


In fact, there are limitations built into the automatic stay provisions that limit the effectiveness for people who have filed prior bankruptcy cases.

In the old days (before the current law came into effect in 2005) people could file case after case in rapid succession, dismissing the ones that didn't work out and filing new ones to stop their creditors.

For most people, these "serial filings" (as they came to be known) were made in good faith and with the best of intentions; someone would file a Chapter 13 bankruptcy to stop a foreclosure, they'd miss a few post-petition payments and the mortgage lender to obtain relief from the automatic stay. Then the homeowner would get a better job and be able to make the payments.

So rather than stay in a Chapter 13 without the benefit of the stay, they'd dismiss their case voluntarily and file a new one - and get a new automatic stay in place to protect them.

Not so anymore. Under the 2005 amendments to the U.S. Bankruptcy Code, a case is presumptively filed in bad faith and subject to a limitation of the automatic stay if a prior case was filed and dismissed within the past year.

SNIP

[mdmc]

34. Either way

If I am in three back breaking accidents over ten years, the ER each time will treat me.
Each time I would go into collections.
Each time I could pay it off over 50 years or go into bankruptcy.
The ER can't get money I don't have. They can get it over time or write it off under bankruptcy.

[pitohui]

66. no the ER will NOT fix you up, you're in fantasy land

first off, ERs are closing right and left, so if you're any distance from an ER, it will cost way more than that 2K you mentioned just for the ambulance

but NO they are NOT obligated to "fix you up," i don't know anyone who got "fixed up" in an ER, they are only required to stabilize you (keep you from dying right that second)

we need 2014 to get here real fast because ERs if they treat you at all -- i myself was personally kicked out of an ER when i was penniless so i very much say "if" -- IF they bother to treat you they will then send you a bill for everything you have & everything your family has -- i guess i was lucky they sent me off to die and i cured myself w/ garlics/crytals, a lot of folks in my same shoes are dead now

if you think the ER will provide care for a long time paralyzing injury you must not understand what breaking your back really is, ain't gonna happen, you're not exactly a moving target, they KNOW who are you are (have time to find out) and you are not getting the physical therapy etc. you need to "fix you up"

if you're broke and break your back you're paralyzed...forever

i don't suggest trying this at home

i know two people denied help for BRAIN TUMORS

[Safetykitten]

11. So true.

[pnwmom]

15. I'm certain that many people don't have the money.

But others do, who instead are making other choices on ways to spend their money. (Cigarettes, alcohol, car leases, cable tv, whatever.)

[Fumesucker]

17. So you punish everyone thanks to the actions of some?

Hardly a liberal or progressive attitude.

[pnwmom]

18. Where have I advocated "punishing" anyone? I'm just saying

that people don't always mean the same thing when they say they can't afford insurance. Many people truly can't. But others are making the choice to spend their money on non-essentials -- unlike health care, which is an essential.

[Dappleganger]

48. Most people I know who can't afford it...

have cut back every single. fucking. thing.

[Jax]

59. Same here Dappleganger. The fucking compassion

from so called Democrats here is fucking sickening but not really surprising anymore.

[HuckleB]

21. You forgot VACCINES!

:rofl:

[shimmergal]

45. The costs aren't necessarily comparable.

If you pay $30-$50 a month for cable TV, or buy a couple of inexpensive bottles of wine a month, there's no way that same amount of money could buy you a health "insurance" policy. Better to just splurge on a few things that a person enjoys, which may actually contribute to keeping them healthier.

[area51]

31. +1

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, and bankrupts people. Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"We will never have real reform until people's health stops being treated as a financial opportunity for corporations."

[Crunchy Frog]

40. If only they hadn't gotten cable TV, they could all be alive.

:cry:

:sarcasm:

[uppityperson]

12. Most auto insurance doesn't have copayments for treatment after accidents

Actually, I don't know of any that do and I work with people who have been in car accidents. Unlike regular health insurance, auto accident insurance doesn't have deductibles. So I guess the best thing to do is get in an accident.

[sandnsea]

13. My son walked stooped for months

He had a herniated disc and couldn't stand up straight. He couldn't get anyone to see him without $500 cash payment. He wasn't working, obviously. The workman's comp was working through the claim, which took about 4 months.

So yes, there are people who walk around in pain without care. Happens all the time.

Funny thing, an acupuncturist ended up fixing him up for $50.

[Dappleganger]

49. How does an acupunture fix a herniated disc?

Does it just take care of the pain? I ask because since July 1 I've had 4 herniated/degenerative discs in the lower lumbar and while physical therapy has brought back feeling in my foot (can walk again) and greatly reduced the pain, it still didn't "fix" the problem. Eventually I will have to have surgery.

[sandnsea]

52. Much milder problem than yours

My husband has back problems like yours so I know what you mean. He's gotten one of those pumps to deal with the pain.

My son's was a temporary thing. I think the acupuncture relieved the pain enough that he could rest correctly and do the exercises that strengthened the area so the rupture could heal. He is really careful to do his exercises regularly now and also careful to lift correctly.

I feel for you. Back pain is miserable.

[Dappleganger]

54. That's good to hear.

I'm always curious how people get through the pain enough to achieve a degree of healing.

Thanks, I'm actually doing MUCH better now pain-wise, just still have numbness (from the compression of the nerves). What kind of pump does your husband use? I'm on the patch as well.

[sandnsea]

55. I don't know

It's the new bigger one, it's implanted in his stomach. They don't seem to use patches much around here. I don't know why. My husband had severe burns several years ago and the home health nurse got patches for him. She had worked with lots of cancer patches which is why she recommended them. They are terrific. He has a 12 hour release medication and other stuff for breakthrough pain, but he's a little out of it a lot of the time. He's hoping the pump will give him more mental clarity.

[Tyrone Slothrop]

47. Seeing as the OP lives in NYS

His treatment would be covered by either NF insurance or MVAIC.

If his back was actually broken, he'd probably get at least a year of treatment free from the involved insurance companies.

(I deal with this sort of thing for a living... Injuries sustained in an auto accident almost never have anything to do with personal health insurance. It's all about the auto insurance.)

[sandnsea]

10. NY Bridge has no deductibles

http://www.ghi.com/nybridgeplan/index.html

$20 co-pay plus pharmacy and vision benefits.

For around $400 a month. I don't know if New York has their own subsidy program, many states do. You should probably contact social services and find out.

It may not help you, but I would bet there are tens of thousands of people in New York state who are thrilled to be able to get care for their illnesses.

[mdmc]

35. I already have full health insurance

my co-payments could be as high as 200 per week if I received all the treatment I am prescribed..

[sandnsea]

53. So you earn $2,000 a week? n/t

[mdmc]

63. no, I earn much less and go without treatment

[mdmc]

69. ..

[Cleita]

20. We need to push for something sooner.

We need to push for the public option in a separate bill or we need to push our states into doing something. This bill is inadequate and it's not universal if it doesn't give everyone access to basic health care.

[HuckleB]

22. I wish.

I really do.

We'll be lucky if we keep the plan and the timeline that's in place now.

[Recursion]

23. Cost, cost, cost

If it's going to be affordable it will have to be heavily subsidized, and probably federally since the states are pretty much tapped.

Do you want to:

A) Increase taxes (remember, all current projections and budgets are based on the assumption that all of the Bush cuts will sunset next year, which we know won't happen)
B) Decrease discretionary spending (I'm all for stopping the wars; that gets us about 1/8th of the way there. What else do we cut?)
C) Borrow more
D) Some combination

[Cleita]

25. All this has been brainstormed by really smart

Harvard doctors at the Physicians for a National Health Plan website yet when they tried to lay their plan before the Congressional committee holding hearings, they weren't allowed to testify and were arrested when they tried to show their plan. There is a way to do it that will cost every person less than what they are paying for health care now. But it will involve a govt. agency becoming the insurer and the private insurance industry being outlawed from offering health insurance. Only then can the health care dollars being spent today on mostly useless health plans with high administrative costs and the need to deliver profits to Wall Street be used for actual health care. It involves cutting out the parasitic middle men, the insurance industry. They are what really is coming between the patient and his doctor. No taxes would need to be increased, just the money that goes to the insurers would need to go to the govt. agency, like Medicare to administer it.

I agree with you the Insurance companies and Big PhRMA should not be subsidized by the Treasury. They should be cut out altogether.

[Recursion]

26. Medicare is pretty damn expensive

With the drug plan, it's about $900 per person per month, most of which comes out of the trust fund. And providers take losses on some Medicare treatments that they end up recouping from people with private insurance.

If we had an social health insurance plan that covered everyone and paid for all treatments, and had equal premiums, those premiums would be about $550 per person per month. So there's about a $350 spread between Medicare premiums and the premiums of a hypothetical total single-payer system, which makes sense because the whole population is younger and healthier than the Medicare population.

What's still up in the air is how we would either

A) Pay $550 per person per month, and/or
B) Reduce payments to health care providers (we've been saying we're going to cut Medicare doctor payments by 20% for decades now. I doubt we ever will.)

[Cleita]

27. Medicare only covers the elderly and very sick people

right now. When you include everyone it spreads the risk and brings down the cost for everyone. It's been proven in other countries. Also, the Republicans have allowed private profiteers to come into the Medicare plan with Medicare Advantage Plans and the disastrous Prescription part D. That is what is causing Medicare costs to spiral upwards. Medicare part D needs to be scrapped and a new plan that enables Medicare to bargain for prices with the PhRMA industry like the VA does. That would cut the prescription costs in half it has been estimated. I would rather see Medicare Advantage programs scrapped altogether. They are another way for Wall Street to get their fingers into the Medicare cookie jar.

[Recursion]

28. That's why I mentioned the $350 difference

between the Medicare premium and a hypothetical premium where we simply divided the cost of all health care services by the number of people in the country.

When you include everyone it spreads the risk and brings down the cost for everyone. It's been proven in other countries.

Well, when you include everyone it puts premium down to $550 per person per month. Now, how do we reduce payments to providers and/or subsidize that premium for people who can't afford it?

[Cleita]

43. I've already said it.

Insurance can't be allowed to cover basic health care. The French actually have basic, government run health insurance for everyone and they pay 80% of medical costs. No private insurance is allowed to cover it. However, insurance can come in and cover the 20% and more. For those poor French the government subsidizes the 20% coverage. That's the only subsidization that is needed. If you cut out the private insurance involvement on basic health care you don't have to cut payment to providers but can actually give them market value of their services. This is the compromise with the insurance companies that we should have cut, not the big welfare for insurance bill that we gave them. If you really are interested go to the website I gave you on another post and read everything they have to say about how this works.

www.pnhp.org.

There are many other excellent websites that give great informations, stats and history. Also, go to the official website of the Canadian Medicare agency. They put out how it works, how it's paid for what is working and what is lacking.

http://www.hc-sc.gc.ca/hcs-sss/medi-assur/index-eng.php

[Recursion]

44. But basic care simply costs more here

You seem to be asserting that's a result of our private insurance industry. Why?

[Cleita]

50. Oh, let's start with Pharoah like income for their

CEOs, like Angela Braley of Wellpoint who took in $13.1million in 2009 http://www.thestreet.com/story/10835171/health-insurance-ceo-pay-jumps.html Also there is the 15% to 30% in administrative costs, unlike Medicare which can do it with less than 3% in administrative costs. Also, high deductibles almost insure that they don't pay out much in claims as most people can't meet the deductible but are still paying huge premiums like $500 a month for getting almost nothing in return. That is just playing casino and doesn't deliver healthcare to those who need it most, the sick. Those premiums instead of going to Wall Street could be put in the pot to be distributed to the health care providers for their services caring for and healing the sick. If you go to my links and educate yourself you don't need to be asking these inane questions on a message board.

[shimmergal]

51. We just need a "cramdown" on

health care charges.

For many procedures or services the provider could still make money if they charged 1/10 their present rate. Don't believe it? Look at the prices charged for comparable procedures done by veterinarians, or for cosmetic surgery of similar complexity--both being areas which are seldom covered by insurance.

This is not true of all parts of the health-care system, of course--a simple office visit to a GP or internist, for instance, is not nearly as well-compensated. But just for the sake of argument, a cramdown to 1/3 or 1/2 of present charges would still allow most "providers" to make lots of money.
'Course its hard to see how it could happen until we do get to single-payer.

[TheKentuckian]

42. If you are going to be mandated to purchase insurance and most have zero choice

in what they pay for then what is the argument against increasing taxes which would be offset by the mandatory 10% of income anyway?

[aikoaiko]

29. Sadly, health care reform will make it more difficult for me to pay out of pocket med bills

Currently, I can and do put $6000 of pretax dollars on a Flexible Spending Account and spend it all on medical bills because my wife and son have chronic health issues. I've been doing this for years and sometimes I spend every cent sometimes before June. By being pretax money, its like I get an extra 1500-1700 dollars to spend on medical bills.

With HCR, that amount will be limited to $2500 which means I'll be paying taxes on the rest of the money and not be able to spend it on medical bills.

[BzaDem]

57. The real question is how much you would benefit from the no-pre-existing condition ban

and possible subsidies if you qualify.

You are looking at one aspect of the bill -- and ignoring the others.

[aikoaiko]

65. It's true that if I lost my job or lost income the HCR would help, but ...

...without any changes on my part but changes brought about in HCR, I will lose the ability to pay about $800-1000 for out of pocket expenses.

It baffles me because this aspect of the HCR actually target those who have been incurring high out of pocket expenses. FSAs are use or lose it type things.

[hobbit709]

39. 10% of nothing is still nothing.

so I can afford to pay nothing I guess.

[BzaDem]

58. That's a talking point, not a reality. If you make nothing, you qualify for Medicaid.

In fact, if you make 133% of the federal poverty limit, you get free Medicaid starting in 2014.

[hobbit709]

60. that does me a lot of good in 2010

[Cleita]

62. Not so fast. Medicaid is so watered down now that only

the most desperate doctors still take it meaning the not so good doctors or patients are relegated to community health centers, which are over crowded so that waiting in line takes in an all new meaning. Sure it's better than nothing, but if you have too much in the way of assets like a savings account with more than $2,000 in it or some income producing savings or property you don't qualify. So some person who has some interest income and a low paying job and basically can't afford insurance or health care with that income can't get Medicaid because he has too much. I see this lower middle class type of discrimination where working class people with a few assets fall between the cracks because they aren't poor enough. Maybe the 133% qualification might make a difference but it still won't cover all in need and actually is not an efficient way to run national health care.

[BzaDem]

56. Then you would basically be screwed under single payer as well. PNHP's plan would create a 7-9%

payroll tax to fund it.

You wanted free healthcare. But that has nothing to do with the set of possible outcomes, even IF single payer was on the table.

[Cleita]

61. 7 to 9 percent is nothing compared to what people

are paying for premiums today for getting nothing most of the time when they need health care the most. Europeans are quite happy to pay higher taxes because of the benefits they get in return.

[Recursion]

68. Delivery costs.

Delivery costs. Delivery costs.

Whether we pay for it singly or individually, it's the costs that are killing us. I hate to give McCain credit for anything, but he had a point about that.