Pre-existing condition? Get insurance with a deductible of $2500.00...

[rateyes]

And, a premium of $6000 a year for a person 50 years old. That's right. That's the premium and deductible for the policy that the government has negotiated for you. Of course, then, there is the co-pay after you pay the first quarter of ten grand. Yes, you can get insurance now...but, can't get the government subsidy yet.

So, if you have a preexisting condition, be prepared, after you max out your out of pocket expenses, to pay nearly $12,000 a year for health care.

What good is insurance that one pays a huge premium for when one can't afford to use it?

This is the problem with the health INSURANCE reform we got, rather than the the health CARE reform we were promised.

But, hey, don't listen to me...I'm just a whiny progressive who didn't get his pony!!

http://www.healthcare.gov/law/provisions/preexisting/states/ga.html

*edited to add link to government site.

[Fumesucker]

1. What a country!

The best health care a rich man can buy..

[Maraya1969]

104. You have not taken into account the government's subsidies

for people who make less than a $75,000 for a family of 4, (?)

You are quoting what the insurance companies are going to get. You are not counting what people actually have to give.

[Lydia Leftcoast]

107. In other words, corporate welfare

and a guaranteed customer base.

The insurance companies fought this bill? Maybe on the surface, but behind the scenes they probably opened the champagne and took the caviar out of the refrigerator at corporate headquarters when it passed.

[Maraya1969]

110. The OP is talking about what a person is going to pay for insurance

and so am I. I'm pissed that they didn't reign in insurance gazillions but don't say the government is not doing its job in helping people have health insurance.

[Lydia Leftcoast]

119. Alas, in many parts of the country, $75,000 for a family of four is not rich

I did the math for myself a while back. Even with the government subsidy, the insurance I would be required to buy would cost more than the policy I recently dropped for being unaffordable.

[Riley133]

137. More people are DROPPING health insurance

I will know more people using the ER as their primary care physician as of January 2011 than ever before. These are people who have *always* had insurance, and they are all over 50 with no dependents. Those are the people who are falling through the cracks, because they 'make too much' to qualify for anything without dependent children and it's too early for Medicare. We do have free clinics, but the hours are often when people are working their low-wage jobs and they too are limited in their care. As someone just asked me when I was trying to figure it all out, 'what do you really need insurance for? If you get sick, just go to the ER'. In Ohio, you can't even qualify for the health insurance exchange if you've used COBRA, so you get screwed if you used your savings to be responsible.

No one seems to be counting the losses, only praising the gains.

I miss Elizabeth Edwards, and I long for the days when she posted here.

[Mimosa]

168. $10,000 ann. deductible, 70/30 plan costs partner and I $895 a month

Co-pays, no Rx coverage until we hit $1,000 (each) deductible.

I fear we'll end up having to drop it. Nearly $900 a month plus co-pays and Rxs is a LOT of money.

[Octafish]

218. $1,700 for a family of four.

Three pre-existing conditions -- three insurers rejected us -- each for a different reason. Oh, after Jan. 1, 2011 they can't reject us for the kid's problem. Hoorah.

[DeschutesRiver]

224. Pretty much the same here from BC, well, except they just raised rates

can't remember to what, as dh paid the bills this time.

We are self employed and 52 and 57. It seems to go up frequently for us, which is why we kept raising the deductible, otherwise we'd have had to drop it long ago.

And we have not been hit with a serious illness or injury yet. I fear now that if we both had something serious happen (and in our fifties, we are past due for that), we probably wouldn't be able to afford the premium, plus the deductibles, plus the co-pay and getting hit with the bulk of the prescription and out of pockets costs ourselves.

I feel the only reason I am still carrying insurance is to get us a first treatment, hopefully lifesaving, for some bad thing, like a heart attack or stroke or accident. After that, we probably can't pay the costs of this kind of policy for long enough to get continuing treatment. If it is some ongoing illness, treatment might not be possible because of the costs of this policy.

[Mimosa]

238. Exactly the same here.

Fear keeps us paying $12,000 a year just for medical access. But the way they keep raising it we may have to drop it and keep our fingers crossed until we're old enough for Medicare. :(


Does a person have to be 65 to get Medicare or is the age 62?

[DeschutesRiver]

244. I also looked into that - it is 65.

I was just hoping it might be 62, but no luck. That was my first thought; the second was oh my god, I can't believe I am old enough to be even seriously thinking of SS or Medicare:)

Here's a couple of links:

http://www.ssa.gov/pubs/10035.html#medicare

https://questions.medicare.gov/app/answers/detail/a_id/108/~/if-i-retire-at-age-62-will-i-be-eligible-for-medicare-at-that-time%3F

Fingers crossed that we both can have some luck of the Irish and hang in until then.

[dflprincess]

141. The OP points out that, while the insurance is available now,

the subsidy is not.

And remember when the subisdy does kick in people who qualify for it will still have to pay the premium costs up front and wait get reimbursed. Also, how much of a subsidy an individual/family receives decreases as income goes up. A family of 4 making $74,000/year is not going to get much help but could have a hefty premium. I know people with family coverage who have gone on COBRA and the smallest premium I've heard any of them having is $1,200/month. And there's still all those deductibles and other out of pockets to pay. Keep in mind that the only expenses that count toward deductibles are those the insurance company decides are covered and the insurance bill does not require that adult vision or dental be among those covered expenses.

The insurance bill is nothing but transfer of billions of private and public dollars into the pockets of the same old crooks (remember, it was Obama that said we needed a public option to "keep them honest"). Over half the bankruptcies in the U.S. are because of medical expenses & most the people filing those bankruptcies had insurance and the bailout bill won't do a lot to change thate.

The government may be subsidizing insurance premiums but it has done nothing to help us actually have access to care - and that is the reform that we needed.

[bread_and_roses]

220. the government is helping insurance companies make a profit

...that's what "subsidies" do. That's what we voted for? And fyi, even with the subsidies, "insurance" is going to be either unaffordable for many.

[kirby]

113. So what if you make $76,000 a year?

Those people aren't allowed to have affordable coverage?

[dotymed]

212. What if you "make"

$12,000 a year? Just die and get it over with...

[Joe Bacon]

232. As Alan said

Don't get sick.

And if you do get sick, die quickly.

[Riley133]

133. What subsidies? Look at this calculator.

First of all, they are tax credits so doesn't that mean you have to pay up front and then get credit on your taxes?

Second, here is a calculator provided by Kaiser. If you are single and make a decent amount, what subsidies?

http://healthreform.kff.org/SubsidyCalculator.aspx

[Techn0Girl]

202. ::FacePLANT:: Holy Crap you're right - you have to pay for a year UP FRONT ....

before you get your money back as a tax refund.

Suck it up poor people.

Oh yeah - if you defaulted on a student loan like a LOT of poeple have over the years - and you DON'T get IRS refunds -
I guess YOU don't get any health care either.

[Riley133]

148. Employer sponsored insurance doesn't get subsidies.

You only qualify for the subsidies aka tax credits if you purchase insurance on your own.

[Mimosa]

166. Subsidies don't kick in until 2014. n/t

[totodeinhere]

172. Even after the subsidies kick in you will have to pay your premiums up front for a whole year, then

get reimbursed the next year. You will have to wait until January after a full year has passed to apply for the subsidies for the previous year on your tax return. So let me ask you, how many people will have the cash flow to be able to pay those exorbitant rates up front for a whole year, then get reimbursed the next year by the IRS? Not many. That's one reason of many why this HCR bill is a total sham.

[Techn0Girl]

201. Are you sure about that?

I mean I think the HC bill is a total sham myself but I never heard anything about the subsidies only appearing on next year's tax bill. Do you have a link to that so I can read about it?

[amandabeech]

225. That does not apply to the new high risk pool.

The poster is talking about the high risk pool.

I'm someone who could benefit from this if the premium were more like $350-400. I can't seem to find a way to squeeze out that last $250.

And there are no subsidies unless your state runs its own pool and feels generous.

[Joe Bacon]

231. Screw corporate welfare.

Thanks to Mad Max, Blanche Lincoln, Landrieu, Ben Nelson and most of all that fucking LIEberman, this is what we're stuck with. More corporate welfare that insures that the pimps running these rackets will continue to receive their hundred million dollar salaries and stock options. And their beancounters will still continue to jack premiums and deductibles thru the roof.

This is change we can believe in because after these parasites finish bleeding us, all we will have left is change--if we're lucky!

[bvar22]

117. After a year long battle, under this "historic" reform,

a rich person with a PEC can NOW buy questionable Health Insurance from a Health Insurance Corporation.

The REAL bomb in the "historic" reform won't explode until 2014 when 35 MILLION Americans are forced to BUY "Insurance" they can't afford to use.
THATS going to go over well.
.
.
.
YEP!
I'm Fired UP I TELL YOU!

I can't WAIT for these people to "Reform Entitlements"!!!

"If we don't fight hard enough for the things we stand for,
at some point we have to recognize that we don't really stand for them."
--- Paul Wellstone

[area51]

2. +1

It was insane to put the insurance companies in the driver's seat, allowing them to continue being the gatekeepers to health care, and get between the doctor and his or her patient.

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."

[rateyes]

3. "We will never have real reform until people's health stops being

treated as a financial opportunity for corporations!!!" Damned straight. Which means we probably will never have real reform. Sad.

[obxhead]

24. We didn't just put them in the drivers seat, we also gave

them a road paved with gold to drive down.

Guarantees of profit.

Zero cost control.

No guarantee of coverage.

Fuck the pony, we didn't even get a rat tail to chew on in the corner, much less a pony.

[inna]

63. "Fuck the pony, we didn't even get a rat tail to chew on in the corner, much less a pony."

LOL. good one. i hear you.

[Riley133]

151. And then they come out with a

vote for us anyway, we suck less campaign? WTF?

[SammyWinstonJack]

213. But Obama is sure proud of his historic BS health "care" reform so STOP whining will ya?

:evilgrin: One thing is certain, neither he nor his family will ever be subjected to this load of crap.

[golddigger]

4. Yeah, but we got a spankin new logo

that says, "Change That Matters."

[rateyes]

5. Oh, well, as long as the slogan is catchy...

:sarcasm: Doesn't matter if the slogan is misleading.

[Generic Other]

88. What change? I don't have enough money to pay for postage to mail the bill

Why do I get the uneasy feeling every extorted dollar spent out-of-pocket by an American means a vote lost to Democrats?

[Jackpine Radical]

131. You want change?

Here's change.

[JanMichael]

162. No no no! HERE is REAL CHANGE!

[Enthusiast]

203. What do you mean by this? nt

[WCGreen]

6. I have insurance right now from United Health ...

We pay 5,200 in a deduction from Mrs. WCGreen Pay Check. We also have paid out over 2700 for scripts and copays...

[rateyes]

8. High deductible??

Unreal isn't it??

[WCGreen]

57. Yes, it is ridiculous....

[DesertFlower]

68. we have united health care.

the company covers hubby, but it costs $127 a month to cover me and we each have a $7,000 a year deductible. fortunately routine check ups are not subject to the deductible.

don't know what the new premium will be. it goes up every year along with the deductible. on the bright side there is no lifetime maximum.

[SharonAnn]

175. To be fair, United Health Care only provides the coverage and cost your employer paid for.

They administer many different types of plans. For employer provided/sponsored health care, the costs, deductibles, co-pays, etc. are what the employer decided they should be. United Health Care provides many different types of plans, depending on what the employer decided to pay for.

Friend of mine couldn't understand why the Insurance Provider didn't take care of the problems in covering health care procedures, they kept denying them. She was outraged because she thought she was "the customer". I explained to her that she is NOT the customer. The employer is the customer and she should complain to her HR department and/or management because they will get the insurance company to take care of things. THEY are the customer. THEY pay the insurance company to administer the plan.

So, yes, the insurance companies shouldn't be driving the health care providers mechanism, but let's get our terms straight.

[DesertFlower]

186. actually we have several choices with united.

we could pay more and have no deductible or we could pay less and get a higher deductible. the company also offers several HMOs.

we've been with united for about 10 years now.

[CountAllVotes]

7. recently had outpatient surgery

The bill is close to $17,000.00 so far! Arrived at 7:00 a.m. and was home before noon.

I guess if I didn't have insurance, the $2,500.00 deductible would be fine with me. How I hate saying that!

How sad is this? :( :( :( :(

:dem: :kick: & recommend.

[rateyes]

10. It is sad. And, little secret, if you didn't have insurance, the cost

of the surgery would have been double that. Hospitals charge those without insurance WAY MORE than those with it in order to write off more loss. Hospitals, even with health insurance reform, continue to bankrupt people.

[CountAllVotes]

32. the cost is over $17,000.00

It has been "repriced" and paid already and the bills are a bit less than the cost billed, yes.

I had the surgery a little over 4 weeks ago. They really could have cared less I'll have you know. I came out of the anesthetic and had a seizure and that isn't even in my medical record! They glued me shut and sent me home and I found blood all over the clothes I had on. My regular doctor was shocked (yes shocked!) by the fact that they did not even bother to put a dressing on the incision much less prescribe antibiotics so I would not develop an infection.

I had a problem emerge right after the surgery and I was very scared. I called up the surgeon's office 3X and they didn't even bother to call me back. I then called this 24 hr. nurse line that comes with my very costly supplemental insurance (try $5,000.00 a year for what?) and I think they did something about this as there is a 72 hour window after surgery that is critical. It was the next morning that I got a phone call telling me to come in ASAP.

I'm on Medicare btw. Medicare for all ... lets hear the cheers now! You get this type of care with Medicare FYI. It is certainly better than not having any insurance at all but this is the type of care you get and only one doctor where I live takes Medicare. His office is filled with patients. The last time I saw him I had a 3 hour wait and got home after 7:00 p.m. that night.

[bvar22]

121. Under Medicare for All,

most doctors would be forced to accept it.
With competition comes an increase in quality.
The problems you cite are NOT problems with Medicare, but problems with the Health Care provider.
These problems should be reported to the authorities.

[CountAllVotes]

180. being said surgeon is the only game in town

I was strongly advised to keep my mouth shut. Period.

[bread_and_roses]

222. "With competition comes an increase in quality" - what planet are you on?

must be a planet where the US has better health outcomes than it does on this planet. Take a look at our rankings compared to single-payer countries. And before you tell me that I am arguing apples and oranges, remember that the current system competes for DOLLARS, not for quality of care.

[kevinbgoode]

34. I went through the same thing! Outpatient surgery, four hours. . .

total bill about $25,000. Deductible BEFORE co-pays: $1500. I am STILL paying a $3300 set of bills from that - a year later. No wonder people live in fear of needing medical attention in this country.

[CountAllVotes]

39. that is disgusting!

A hospital stay is much worse however. I've had 2 other surgeries prior to this recent one. I was hospitalized and in the ICU the first time around - that bill was about $100,000.00. The second surgery cost more actually for some reason.

I've racked up over $250,000.00 in medical bills since November, 2009.

I am still alive barely here.

When I went in this last time around I announced as they hauled me in, "The is it. No more." When I saw the physician's assistant (surgeon not available) the other day she was trying to talk me into yet another risky procedure and I told her flat out no way. That didn't go over so hot believe me.

[pnwmom]

93. That's the thing. It's the health costs that are the real problem.

Given health costs, the insurance amounts in the OP are not out of line. In fact, they'd be much less than what would have been available a year ago.

[Enthusiast]

204. Insurance serves no purpose.

They do not contribute anything to care. Nothing. All they do is remove the consumer from their money to administrate a program that could be done far far cheaper. The insurance industry deserves no cut of the health care pie, absolutely none.

[edhopper]

9. I have benign prostate problems that

will probably result in cancer at some time in the future (statistics point that way). I see a urologist regularly to keep an eye on it. I am insured through my wife, who is being pushed into insurance that will not cover me.
I am in my 50s with a preexisting condition. I will not be able to afford insurance at these rates.
I feel I have a death penalty over my head.

[rateyes]

11. Wow! How sad is that...

and, they say everyone will be covered. Uh huh.

[rateyes]

12. And, good luck..

hope it stays benign.

[5X]

15. There are your death panels....

we will inflict them on ourselves to keep from bankrupting our heirs.

[juajen]

246. Heirs

Heirs do not have to pay the bills, the estate does. If there is no money in the estate, the bills go unpaid, but the children are not liable.

[Riley133]

153. The 50s age group is getting screwed big time

Can't afford the health insurance exchange, can't qualify for Medicaid, too early for Medicare, can't get hired....who is watching out for us? Best wishes for continued good health to you. I don't have anything more to give you, and I'm sorry that I don't. Why we didn't get single payer is beyond me.

[Enthusiast]

205. You have no political representation.

The insurance industry, the for profit medical delivery system and the pharmaceutical industry, now they have representation, the best money can buy.

This was made abundantly clear to us during the health care reform debate.

[Name removed]

13. Deleted message

Message removed by moderator. Click here to review the message board rules.

[rateyes]

14. Maybe they will look at the government website...

then, maybe not. Some folk don't want "too much education."

[golddigger]

18. I would post it for them, but I already

made a mistake of posting in the dungeon about something like this, the fur is still flying.

[rateyes]

21. got a link to that?

might make good reading.

[golddigger]

30. It was one of the OP's where Obama joked

at a $30,000.00 plate dinner. I assumed that is why you made this post.

[rateyes]

35. Nope. Didn't see it.

[Curmudgeoness]

26. Who cares if fur flies. Isn't that part of the discussion on the

DU "discussion" board? Can't let people who refuse to believe the truth and admit that there are problems get to you. The rest of us are looking at both sides, sometimes staying in the background. But many people besides the condemners are seeing what is posted. You just remember that.

[Mimosa]

171. The Gov sponsored plan in my state is pretty much what we have now, run by the same company

And it is $600 a person. So that would be $1,200 a month instead of the $895 a month we pay now.

[Occulus]

72. No, actually, those fucking cowards don't have the courage to do that.

I have FIFTY PEOPLE on my ignore list, many of them among the worst offenders when it comes to this POS legislation. By "worst offenders", I mean the motherFUCKS who were championing this shitty fucking deal.

NOT ONE of them has posted on this thread. Not one.

In poker, that is called a "tell".

[slipslidingaway]

130. +1 n/t

[metapunditedgy]

182. Since so many candidates are campaigning on the success of hcr, they

probably felt there was no need to add to that overwhelming din...

[WorseBeforeBetter]

140. Don Quixote and windmills have been added to their repertoire. (n/t)

[liberation]

147. Finally! A new talking point...

... I was getting a bit disappointed with those DLC interns, they really squeezed those canned responses for as long as they could.

[WorseBeforeBetter]

154. I know. The entertainment value they provide is half the reason I tune in these days.

The other half is to glom on to any remaining substance, like what this site provided for many good years.

[Rex]

16. Washington doesn't care about The People, they care about The

Corporations. And if The Corporations say The People can die as far as we are concerned then Washington says, "sure how many, we don't care about them either".

[slipslidingaway]

17. "These costs may be higher, if you go outside the plan’s network."

Quote from your link, if you have a serious illness hopefully there will be a wide range of providers that are "in network."

knr

[rateyes]

19. live in a rural area, you may have to travel several hours to find

a provider willing to rip you off.

[slipslidingaway]

31. It does not even have to be a rural area ...

http://pnhp.org/news/2010/august/doctors-hard-to-find-for-patients-in-massachusetts-first-for-profit-health-plan-nej

Doctors hard to find for patients in Massachusetts' first for-profit health plan: NEJM article

"...The plan's failure to provide adequate access to doctors for its members raises grave concerns not only about Massachusetts' reform, but also about the recently enacted national reform, the researchers said. The national plan closely mirrors Massachusetts' reform, but relies far more heavily on for-profit insurers.

The report points out that even when patients have insurance, profit-driven plans may discourage them from getting the care they need by "rationing by inconvenience..."

[Curmudgeoness]

20. I want my pony too. There were so many flaws in the legislation

that it makes me want to cry. Or explode. I am furious that this went into effect over such a long time, allowing insurance companies to continue to raise rates as high as they want before they are stopped (if they are ever stopped). I am furious that having insurance will become mandatory, meaning that we will all be required to spend a small fortune in these higher rates. The deductibles and co-pays that you are citing are as good as having no insurance for most of us, even with pre-existing conditions (since that is an all-encompassing term for just about anything).

It isn't that we didn't get our pony that angers us so much. It is that all we got was a truckload of pony shit.

[rateyes]

23. Several truckloads

:hi:

[Enthusiast]

206. Makes good fertilizer.

:fistbump:

[Octafish]

219. Thank Moon Wall Street got their bonus money, though.

And they got us the taxpayer on the hook to pick up the tab for their next bailout, too.

[kestrel91316]

22. I had a supposedly great policy a few years ago that had premiums of over $6k a year and

a FIVE THOUSAND DOLLAR DEDUCTIBLE (or was it TEN?), and a significant 80:20 copay after that. I gave it up, simply couldn't afford the deductible and copay on top of the premiums. Better off with no insurance and take my chances at staying healthy.

[rateyes]

25. Unfreaking real!

I hear you. But, soon, you will be forced into such a policy.

[kestrel91316]

44. Wrong. Such a policy will be illegal, IIRC. Deductible too high. Out-of-pocket

too high. And I, a self-employed person, will probably qualify for the subsidy.

I'm not proud. I'll take it.

[rateyes]

46. The subsidy for the premiums...

still have to come up with the deductible and copays. $2500 for deductible ain't chump change.

[gkhouston]

58. Such a policy will be illegal when??? Because that's what our "health coverage" (ha!)

looks like, and it stinks on ice.

[Skittles]

138. LOLOL

WHAT THE FUCK PLANET DO YOU LIVE ON?

[Riley133]

146. Nope, not illegal - it just has to be justified.

"Similarly, starting in plan year 2011, insurance companies that jack up rates will have to disclose requested premium increases publicly. If that rate increase is found to be unreasonable, the insurer may be prohibited competing for your business in the new state-based exchange that will begin operating in 2014."

http://www.healthreform.gov/about/answers.html

[CrispyQ]

64. "...take my chances at staying healthy."

My husband's advice for living in New America: Get in the best physical condition you can & be able to live on an $8 an hour job.

Sad, isn't it?

[Enthusiast]

207. Well, it's not too far

from the truth. It doesn't set too well with those of us that have compromised health already.

[Autumn]

27. Damn good insurance finance reform.

Of course as health care reform it doesn't amount to shit. Be glad you didn't get a pony, with rates like those you couldn't afford to feed it. K/R

[stray cat]

28. Do you know what the going rate is for insurance anyway?

I pay at least 10,000 a year for a young single healthy employee. In total I pay 40% on top of the salary in extra benefits - over 14000 a year that the employee never sees and doesn't have a clue is being paid as part of her benefits package. Most employees are ignorant of the costs of their benefits because it isn't taken out of their pay check - including me....

[rateyes]

29. Must be nice to have the 10 grand to pay the premiums with, huh?

Pretty fucked up, isn't it?

[slipslidingaway]

38. Then the question should be why can so many other countries...

provide coverage at much lower costs?

Unfortunately, that is a discussion we never had during the health insurance debates.

Explore other alternatives from various countries, at least open the door for the future and invite them to the WH instead of the insurance, pharma lobbyists.

:(

[CountAllVotes]

43. maybe I should move to Ireland

That is if the economy ever improves there. It is a lot less to see a doctor there and they will come to your home to see you.

My doctor is threatening to toss me into a nursing home eventually. I will not allow this to happen as long as I can still walk, talk and think. God damn them all!

[slipslidingaway]

47. Maybe we should at least allow discussions of other systems...

that is a real injustice IMO.

Hope you are recovering. For the moment I'm not even looking at the bills for my husband.

[CountAllVotes]

49. yes, you are so right

I was there visiting a few years ago. When I arrived I had the same problem that led to the 3 recent surgeries. I had no idea I had this serious problem.

They were worried about me at the hotel I was staying at and they said they would call me a doctor right away. When I heard that I found myself saying, "Oh no, that is alright. I'll be ok. Just forget it but thank you." I was afraid I'd get a big bill or something.

In hindsight, that doctor's visit might have cost me about $50 or something at the most. You get brainwashed into fearing going to a doctor because of the cost.

To hell with your health ... move along now has been the story.

Thanks for you good wishes. I was advised I have another 18 mos. to go before I might be "recovered" whatever that means. :(

[slipslidingaway]

79. My sister lives in the UK and we had the doctor out a couple times when...

the children were little. One time we got a very small bill and the other time we never received a bill. Although they have private insurance in addition to the NHS they are very happy with their NHS primary care doc. Even though they are both more conservative, they think that we are so backwards in the US with our HC system.

Think positive, recovery is partially what you make it :)

[Enthusiast]

209. It's clear why they didn't

want these discussions. They didn't want us to know how deficient our system was. And that is a fact.

[Enthusiast]

208. The Nursing homes around here

are so bad that I have adopted an alternative plan if they ever want to do that to me.

I'm with you. I'm ready to go to another country. Trouble is no one will accept sick and unproductive immigrants.

[MsPithy]

155. Here's the best graph showing what countries spend on health care!

Make sure you see the United States in orange, it's easy to miss.

http://boingboing.net/2010/01/25/the-cost-of-health-c.html

And, keep in mind, our wonderful Health Care Reform does not one fucking thing to change this graph.

[slipslidingaway]

235. Thanks for posting the graph and welcome to DU. n/t

[Mimosa]

173. ^ Many of us wonder about that ^

The doors were closed to participation and a real discussion. :(

[Curmudgeoness]

41. Maybe it is time for employers to open up about the premiums

that they are paying for employee's health insurance, or any other benefits. I do accounting, so I see the premium statements, but it is not common knowledge with the other employees. Maybe more people would appreciate what their pay "really" is for their employer if they saw these things.

I guess we are lucky where I am now. The premium for a single employee are $350 per month. This is for $2500 deductible with another $2500 in 80/20 co-pay. Of course, don't try to use it but hey, if you have a major problem, you will be ok compared to having nothing.

[pnwmom]

97. And that is the crux of the problem. The costs in the OP

represent a real savings, but that won't help people who can't afford them anyway.

[liberation]

149. Why the red herring?

Technically, socialized medicine is not only good from an individual citizen stand point, but for labor costs as well... since business have reduced expenses due to reduced cost of providing benefits.

That is why Canada, for example, was able to compete very aggressively to capture foreign manufacturing plants because they can offer lower labor costs than in the US. And their single payer is in a very large part responsible for that edge in competitiveness.

[Hugabear]

33. Hey, they never promised us it would be GOOD health coverage

Unless, that is, you're a health insurance company. Then it's very good reform.

[quiller4]

36. I'll took it. That cut $1,000 from my current deductible and my premium isn't

going to be $6,000/yr but $4,800 but both are a big improvement over my current $7,200.

[slipslidingaway]

42. Are you eligible if you currently have coverage - check the FAQ page...

also you might want to check which providers will be in this network.

[rateyes]

48. You aren't eligible. Have to have been uninsured for 6 months

before getting the insurance offered here. Merry Christmas!

[bread_and_roses]

223. I guess they're hoping lots die in those six months

I mean, what the hell are sick people supposed to do for those six months? It's insane.

[riderinthestorm]

233. In IL, you have to be denied first by the insurance companies, wait 6 months to apply (uninsured)

and then once you apply, you are put on the waiting list which currently has a year's wait....

The US government "merged" with our state plan to expedite the process doncha know, so the state rules are the ones in action right now.

Which can mean a 2 or more year wait to get into the high risk pool....

Or or course, you can get caught in the snare that we faced. My husband's COBRA expired in May and we applied for coverage fully expecting to be turned down (he has a very serious PEC). He wasn't. He was offered a policy at $1300/month. That is not a typo. We pay $15,000 per year for health insurance for him alone. And he doesn't qualify for the high risk pool here in IL because he was never "denied".

The insurance companies aren't stupid - they're going to game every patient to see what's the most maximally profitable for them.

[Mimosa]

240. EXACTLY!!! People have to PROVE they've been denied and the paperwork is arduous.

People who are very sick don't have the energy and drive to jump through all those hoops. :(

[quiller4]

37. You also fail to mention that all screening tests are exempt from deductible

[slipslidingaway]

45. Read the link in the OP n/t

[Riley133]

250. Not necessarily (see link)

The devil is in the details.

http://www.ohio.com/news/top_stories/103227719.html

[Missy Vixen]

40. I posted the actual numbers for our insurance premiums under

the Washington State high-risk pool a little over a month ago. The cost per month compares to a second primary mortgage payment. The deductible was $2500, and there were co-pays for prescription drugs. I also mentioned that my husband requires $500 worth of prescription drugs to stay alive every month. I just turned fifty. We both have pre-existing conditions.

I was told that I could "certainly" afford it. After all, after our house payment and the insurance premium, we'd have $900 per month left for food, utility bills, all other payments (car insurance is $125, for instance,) and saving to replace our fifteen-year-old vehicles.

Whomever said that it's a good thing we didn't get the pony - after all, we couldn't afford to feed it! - is right.

[Unvanguard]

50. Yes, that's how high-risk pools work. We have the mandate so that we can get rid of them.

But we're supposed to be against that, too...

[LWolf]

"Care" is a pony I'm not going to get.

I have what is considered to be "good" insurance. Not high-risk. I couldn't afford care after paying the premiums, though, without ever approaching the deductible.

That "good" insurance just went up 30%. That's the final figure released to us this week; it takes effect October 1st.

Care is nowhere on the table.

[rateyes]

52. raking in premiums, and not having to pay claims because people

are underinsured equals a windfall for insurance companies.

[LWolf]

54. That's for damned sure. There are many of us out here. nt

[ejpoeta]

51. that was basically what we had available to us through my husband's work.

last year when i was pregnant, we had a $250 deductible per person plus 80/20 after that i think. then they dumped everything and switched to the insurance that is the worst one with a $5000 deductible per person and then 80/20 after that i think. that's when we applied for the state insurance. kids were already on child health plus, but that was just untenable. might as well have put that premium in an account instead and hope for the best. luckily we were just under the cap for the insurance. the worst part is the idea of mandating people to buy into a broken system that you can't even afford to use.

[BlueIris]

53. Damn you. Kidding. I'm a whiny liberal who expected a pony, too, so I

feel you. My pony was to be named Basic Human Rights. Don't see my pony showing up anytime soon (alas).

[Cleita]

62. Good one. Basic Human Rights seem as exotic

as a trip to another galaxy these days.

[liberation]

156. You are in the slippery slope of unrealistic expectations...

... first you would expect Democrats to fight for the people first rather than compromise with corporate interests before even daring to make a movement, then you won't find it amusing when a Nobel Peace Price winner find "World Peace" an unrealistic goal to make that makes a nice butt for a joke, and then you expect health care to be a basic human right like it is in every other industrialized nation.

Come on! Expecting politicians to actually do their damned jobs and represent the people who elect them almost as unrealistic... and don't even get me started with the sense of entitlement some liberals feel that voting is not only a right but the main tool to request accountability by citizens. Silly liberals, they don't know that "presidentin' is hard?"

[dixiegrrrrl]

55. for those who might need an outpatient alternative

We are lucky where I live, we have a free /low income clinic, plus pretty cheap "regular"
Dr. offices. Who still do take Medicare, way out here in the sticks.

Mr. d. got an x-ray and office exam, blood work done, for 110.00. at the "regular" dr. he sees.

I have used the free/low-income clinic in the past for a basic single issue diagnosis.


Here is the list of national clinics:

http://www.needymeds.org/free_clinics.taf

[Warpy]

56. You get the gold star

That cowardly "reform" did nothing for me, either. Oh, the companies have to write those policies now, but out of pocket expenses are obscene and those companies still don't have to cover my primary condition, which is a lulu and renders the gold plated fur lined policy a glorified accident policy. No thanks, boys, I'll pay out of pocket and hope I don't get cancer until after Medicare kicks in a few years from now.

Not at least lowering the Medicare eligibility age for a full price buy in was the biggest mistake they made with this thing. Insurance companies don't really want anyone over 50 unless it's for a more lucrative Medigap policy.

HCR did a lot of good things for people under 40. It did practically nothing for those of us over 50.

[Safetykitten]

59. Ah...the high risk pool that soon many other will be jumping into as

the economy tanks further. But it's OK! The people who have insurance and Canadians will be here to tell you how it really is a good thing, suck it up and oh, by the way, you don't deserve President Obama because you are whiny.

[stevedeshazer]

60. +1

[Cleita]

61. Before I got on Medicare, I had to carry such an insurance.

I never met the deductible so I was paying for all my medical care and handing over almost $500 a month to Blue Cross. I figured it was cheaper for me not to have insurance and to keep my fingers crossed until I qualified for Medicare. I mean that kind of health insurance is about as much use as a mail box with no slot to shove the mail through.

[KansDem]

65. But...but...Health-insurance CEOs just want a little more money for their work...

Health insurance industry CEO salary survey, stay calm for this

Meet some the parasites:

Ron Williams - Aetna
Total Compensation: $24,300,112

H. Edward Hanway - CIGNA
Total Compensation: $12,236,740

Angela Braly - WellPoint
Total Compensation: $9,844,212

Mr. Williams of Aetna, if you take 50 weeks at five days a week, earns $97,200 a day. But he probably has to work some nights and weekends...

[WestSeattle2]

66. The health insurance industry is killing the goose that has laid

golden eggs for them for the last 30 years - their own greed is sowing the seeds of their ultimate destruction. This simply can't continue; it's mathematically and macro-economically impossible. If I was a young person graduating from college today, I would not even consider going to work in that industry. Their days are numbered, it's only a matter of time. Unfortunately, due to congressional, and dare I say, White House dereliction of duty; untold millions of lives will be destroyed before there is single-payer.

[Enthusiast]

210. Single-Payer is the

only possible solution. And the for-profit medical delivery system has to come to an end.

[truedelphi]

67. Hi rateyes. Long time no see.

Glad to read your OP today.

And I am quite discouraged about my getting an Obama-supplied pony that immediately ran away and I can only get the pony back if I pay a deductible, a co pay, and 20% of the costs. Plus worst of all, fill out onerous forms so that the insurer will agree that I deserve the treatment, and on and on.

[johnaries]

69. It's only a temp program, until the Exchange is established.

This program may be able to help you, if you’ve been locked out of the insurance market, until 2014. In 2014, you will have access to affordable health insurance choices through a new competitive marketplace called an Exchange

Exchange
A new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Exchanges will offer you a choice of health plans that meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through Exchanges and you will be able buy your insurance through Exchanges too.
. You can no longer be discriminated against based on a pre-existing condition.

The Pre-Existing Condition Insurance Plan will be available in every state—but the program may vary depending on your state. For years, many states have run programs – often called “high risk pools” – to offer insurance if you have a pre-existing condition. To build on what states are already doing, states can either run the new program with resources made available by the Affordable Care Act, or rely on the U.S. Department of Health and Human Services to provide coverage.

http://www.healthcare.gov/law/provisions/preexisting/about/index.html

[eridani]

90. How nice for all the Platinum and Gold People

Silver, Bronze and Dirt people will have to buy shitty underinsurance that we can't afford to use.

[Missy Vixen]

139. Question

How many people do you believe will still be with us in three years to take advantage of the "exchange"?

Those who are paying the equivalent of two primary mortgages per month for care they can't afford to avail themselves of will do whatever they can to stay out of the doctor's office. If they're still living indoors, they'll be lucky. They will drain every last cent out of savings, or any discretionary income, to keep paying that premium!

THREE YEARS. OVER TEN THOUSAND DOLLARS A YEAR FOR $2500 in DEDUCTIBLES, 80% CO-PAYS.

How else can I explain this to those who continue to insist that this is a workable plan? If you are over 40, have kids, or get paid less than $100,000 per year, you can't afford the premium, DESPITE the "credits"!

How many of you can afford to set fire to roughly ten thousand dollars a year without significant damage to your household budget?

[liberation]

160. Furthermore:

What does the exchange do that alters in any significant way, for the better, the issues pointed out in the OP.

[DesertFlower]

70. my friend has acute leukemia. she was

diagnosed in late february. went into the hospital 3/4. developed 2 infections after the first round of chemo. after the 2nd round 4 infections. she was in ICU for over a month. they were talking to her husband about "ending her suffering". miraculously she came out of it, but had to go to the rehabilitation part of the hospital to learn how to walk again. after 4 months in the hospital she went home, but was re-admitted 2x for infections. her only chance of extending her life 3-4 years was a t-cell implant. the odds of it working are only 40%. she had it last month and was released from the hospital the other day after almost a month. she has home care nurses and has to go to the hospital 2x a week for check-ups.

fortunately her husband has insurance that does not carry a lifetime maximum. can you imagine how much the bills are? got to be up in the millions.

now you know that those costs are going to be passed on to us in higher premiums. the insurance CEO's have to keep making their 22 million a year.

[slipslidingaway]

77. Most likely a T- cell depleted transplant, not an implant ...

and it could be more than 3-4 years, we're hoping it will be. :)

Odds really depend on a variety of factors. We're happy to have the insurance without a lifetime cap and also to have leading cancer centers available "in network." Sloan is one of the few, if not the only, center that does T-cell depleted transplants.

But that insurance policy comes with a price of an annual out of pocket maximum of just under 12K, people talk about deductibles, but they need to look at the annual out of pocket max, lifetime max and the availabilty of treatment centers.

This type of transplant runs about 250K, wish I did not know this info.

Best of luck to your friend!

[DesertFlower]

83. they had to find a donor for it. her

brother was not a match. supposedly the donor was a 95% match.

thank you. every time i think i'm able to deal with her passing, something comes up and i start crying again. she's only 62.

[slipslidingaway]

86. Not following, is she alive or not? Sorry if she did not survive, but ...

I did not read that in your original post, it sounded as if she had the transplant and is having home health care.

:shrug:

She will be closely monitored for at least the next year and if she had a TCD transplant her immune system will probably take longer to recover.

Sometimes a perfect match is not always the best, in fact identical twins have a lower success rate, you need the new system fighting the old system AND any leftover cancer cells. It is called graft versus tumor/leukemia and can have a very beneficial effect. That is a major reason they are doing reduced intensity transplants on older people. Actually it is what they are trying to balance with the T cell depleted transplant, if you reduce the graft versus host disease too much, it could sacrifice the benefits of graft v tumor/leukemia. But first you have to survive the transplant ... hence the TCD transplant.

If she is still alive please do not write her off, my husband is scheduled for admission on Tuesday for a T-cell depleted transplant.

Ten years and counting
http://community.lls.org/message/61113#61113

[DesertFlower]

98. she's alive. i wish she had a

more positive attitude. when i talk to her i try to get her focus away from her illness and on to other things.

she's always been an "anxious" person and now she's just so scared. they told her that she won't feel well for 2 years.

BTW. she's a DUer. we met on DU in '06 and immediately became friends. she hasn't posted since she was diagnosed and i never mentioned her name or asked for prayers. she wouldn't want that.

you mentioned Sloan. my sister in law works in sloan in new york city. she's head of the department that does echocardiograms.

my thoughts and prayers are with you and your husband.

[slipslidingaway]

103. Thanks ...

did she have her transplant at Sloan? Not sure if any other centers do the TCD transplants. Maybe she lives in the city, we are a couple of hours away, but stayed at Hope Lodge in NYC back in June while undergoing daily treatments of decitabine, which did not work.

But the induction therapy did work, there was a month's stay at Sloan, now looking at another month plus and a couple of months at Hope Lodge.

We were told that the immune system may not fully recover for up to two years. A non TCD transplant patient can recover faster, then again they are more likely to be dealing with GVHD and be on immunosuppresants which can have a negative effect. It is all very much still a balancing act and a work in progress.

Thanks for the well wishes and best of luck having your friend try and move past this tough disease.

[DesertFlower]

106. she had it at prentice women's hospital

in chicago. she lives in a burb outside of chicago. her last bone marrow test before the implant said she was cancer free so i was a bit surprised that she still had to have the implant. i'm not familiar with this illness and there's not much info on the internet about the transplant. she usually researches everything, but when she was diagnosed she didn't. they told her that she had to have the implant in order to have any kind of remission.

[slipslidingaway]

112. Just taking a guess ...

but there are other bone marrow failure diseases that may have been present in the BMB indicating that a transplant was a shot at a longer term cure.

The best you can do is be supportive, again it is balancing act between not wanting to ignore what is happening (it certainly is real) and making sure one does not dwell on the disease. Take your cues from her, maybe she really does need to talk, but also try and present a slight diversion when you think it appropriate. If her counts are still low (susceptible to infection) and I suspect they are, then being confined to limited places and a limited diet can be isolating enough. As for the research, it is difficult information to read, both the long term prognosis for a percentage of people and the scientific data, add the effects of chemo to the brain and it could become very difficult if not impossible.

If nothing else send an email saying Hi. Hopefully she will make the most of the good times and that will encourage her to have a more positive attitude. It does not always have the desired outcome, but there is something to the old saying "mind over matter."

Best of luck and thanks :)

[DesertFlower]

188. i know they keep telling her how sick she is.

hopefully the transplant will work. she was afraid of having it. she said "i don't think i'm going to make it", but she did.

i e-mailed her a few hours ago but haven't heard back from her yet.

again you and your husband are in my thoughts and prayers.

[slipslidingaway]

236. I hope your friend does well ...

in the future, glad you sent her an email just so she knows people are thinking about her.

Thanks for the kind words, thoughts and prayers, I will not be checking into DU very much anytime soon.

[BzaDem]

96. Reform removes all lifetime maxmimums, and prevents them from raising your costs when you get sick.

Sorry I'm not on the HCR bashing train. If you want to hear more negative bullshit about the bill, there are plenty of other people to spread that.

[DesertFlower]

100. i'm not bashing HCR. hopefully it will get

better in the next few years. i wasn't sure if it removed lifetime maximums or yearly maximums. there's a big difference.

i am bashing the insurance companies. why does the CEO of united need to make 22 million a year? from what i've heard and read they were raising their rates last year in anticipation of HCR.

[slipslidingaway]

105. There sure is a big difference between the two. n/t

[eridani]

200. But leaves them free to reject any claim that they can get by with rejecting n/t

[Riley133]

252. Keep silent, then

The rest of us will fight for reforming the reform and getting it to where it needs to be - a truly affordable, single payer plan.

[colsohlibgal]

71. Historic? Not!

This insurance "reform" might do some good for some people but maybe not too quickly. Others will lose. The democrats have a lot of nerve running around calling this bill "historic" - well, maybe as a wet dream for the corporate insurance/drug company vultures who have been robbing us while they are killing us.

Only in America.

Of course people like Huckabee, apparently trying to out crazy the crazies, think we shouldn't spend a dime on people who have pre existing conditions.

[JDPriestly]

73. Health insurance companies should be by law non-profits

If we can't have a public option, we should at least have that guarantee. It is cruel to make people pay that much for medical care when the actual care does not cost nearly what is charged.

[Riley133]

157. Hospitals charge a fortune, tho, even when non-profit

I think greed will always find loopholes.

[KG]

74. they're going to get around to 'fixing it'. real soon. any day now.

[liberation]

163. Right after we elect them to fix the fuck up they created...

... I love circular logic.

[NNN0LHI]

75. How much income would someone have to be making to qualify for those rates?

Do they expect someone making minimum wage to pay that or is there a sliding scale?

Don

[NorthCarolina]

76. But, but, but...that's such Progressive Legislation!!!

Well, progressive from the viewpoint of a conservative DLC New Dem anyway.

[progressoid]

78. Woo Hoo!!!1!

We won!



Right?

Yeah, I remember. We won.




:sarcasm:

[WinkyDink]

80. I almost have that, I'm healthy, AND it's through a union contract!

$250 deductible/ $540/mo.

[Techn0Girl]

81. "Any plan I sign must include an insurance exchange:...including a public option "

http://tpmdc.talkingpointsmemo.com/2009/07/obama-demands-the-bill-i-sign-must-include-public-option.php

"Any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans - including a public option to increase competition and keep insurance companies honest - and choose what's best for your family."
Barack Obama, July 2009

and

"The Bill I Sign Must Include Public Option"
Barack Obama,July 2009

http://tvnz.co.nz/health-news/factbox-obama-quotes-healthcare-2866397

"Part of the reason we want to have a public option is just to help keep the insurance companies honest."
Barack Obama, July 2009

"Read my lips: no new taxes"
George H. Bush , August 1988


Same as it ever was ...

[slipslidingaway]

84. And Medicare was going to negotiate drug prices, Billy Tauzin...

"the evil" in campaign ads became Billy the beloved behind closed doors.

One sixth of our nation does not have insurance, and many people that have insurance cannot afford the care. This historic insurance reform just kicked the can down the road.

:(

[Hell Hath No Fury]

216. La la la la la la la la ---

I have my fingers in my ears and I can't hear you.

(My imitation of many of the True Believers. :D )

[slipslidingaway]

82. Considering that in poll after poll for the last decade plus, over half the people...

are in favor of a HC system funded by taxes, you have to wonder why any discussion along these lines was silenced in the recent debates.

Or you could just say it was historic.

:puke:

[MisterP]

195. "historic" and "the GOP is against it, that should be enough for you" nt

[Riley133]

249. Look at the appointment of Liz Fowler. NFT

[mdmc]

85. It is the best the DLC would allow Obama! A WIN!

My health care cost went up 15% this year after I jumped through hoops to get discounts, I pay a double digit increase. If I didn't jump through hoops, I would be getting a 30% increase..

:mad:

[dpbrown]

87. Ain't that the truth.

Well, voters are about to hand Congress back to the people who ruined Washington in the first place, so prepare for things to get worse.

[Tansy_Gold]

89. There were so many of us who warned about this long before

HCR passed. We were excoriated here, and some of us are no longer DUers because of the abuse that was heaped on us for daring to complain about not getting our ponies.

We were told over and over that it wasn't perfect but it was damned good. We said it was terrible.

We were told over and over that it needed to be passed and then it could be "fixed." We said it wouldn't be, and it hasn't been.

We were called traitors and PUMAs and DINOs and Obama haters. We said we just wanted meaningful health care for everyone.


We knew this would happen.

I'm not saying, by any means, that those who are posting now are the same ones who yelled at us before the bill passed. Not at all. But for those who DID abuse us




TG, NTY

[Cleita]

95. Amen.

Right now I'm just sitting back waiting for all the hens to come back to roost, then maybe we can post again on what we as a nation need to do to get decent access to decent health care for everyone without having to endure all the nastiness aimed at us.

[NorthCarolina]

99. And they wonder why a majority of the people are calling for a third party.

The answer is simple really, America yearns for a party that advocates for the people. I realize the conservatives control the tone of the conversation on DU, and would have you believe that they represent the largest piece of the pie in the Democratic Party, but it's really nothing more than unsubstantiated puffery. America will move to the left and join the rest of the western world, it's just a matter of time, and your DLC New Dems will be about as in-style as your late model Edsel.

[Safetykitten]

109. This was one of the biggest of the "this is NOT a good thing" warnings that were completely shoved

aside. Now we all pay, and soon the people who think they are safe and sound in their company plan? They better start looking over their shoulder, because they are next in the fine tuning phase.

[pnwmom]

91. What do you think a 50 year old with a preexisting condition

would have had to pay a year ago? Far more than that -- if s/he could get any insurance at all.

[slipslidingaway]

101. How do the pre-existing conditions work in other countries, lost employment ...

in other countries? Then again we never had that discussion did we, and that is the saddest part of this whole reform. Anyone who tried to advance the topic was ignored. It was very clear during the presidential debates and continued until the insurance and drug protection act was signed into law.

Also the argument you are making does not matter to many people, if the person still does not gain access to the best care, what does a policy mean? This focus on insurance is totally wrong, we need to focus on care.

[pnwmom]

108. Millions more people will be able to afford insurance than before.

But I realize that still won't solve the problem for many others. I remain in favor of a public option as a step toward Medicare for all. But I don't think we should denigrate what Obama did accomplish, against great opposition.

[slipslidingaway]

118. The problem is you are still talking insurance, not access to care...

Obama could have at least advanced the discussion to a national HC system, even while he made a deal with Billy that went against his written HC plan. At least the conversation would be out in the open, but that is not what happened. Some people blame Baucus for him not inviting anyone to testify about a national, not for profit HC system, but Obama was the one setting the tone. Or he should have been, either he has power to influence on some level or he does not. For me the answer can be found in who was invited and who was called upon to speak at the WH kick off meeting for HC and the WH townhall televised meeting a few months later.

He gave a speech in late 2008, saying "That is not who we are!" when speaking of other politicians moving to the WH and then making deals that went against their detailed plans, then he did the exact same thing. I've posted all this before, with links to his speech and his plan and have been met by silence. So the question is did he mean what he said or was it said just to get applause and votes, at some point people have to question.

:shrug:

Speeches can be great, actions that mirror those speeches even better.

I'll be very curious to see how Medicare is handled in the coming months or years, there is no way in my mind that the government can continue Medicare in the present form with all the boomers moving to Medicare. And under the historic HC reform bill we'll use Medicare saving to pay for subsidies that will go to private insurance companies, guess that will help - someone???

[Skittles]

145. they don't get it

they just do NOT.FUCKING.GET.IT.

[slipslidingaway]

158. Maybe they'll get it when in addition to the maximum out of pocket...

that needs to be paid you might also have to add travel, lodging and food.

There is a reason so many people file for bankruptcy while Having insurance.

:(

[Skittles]

161. and their "solution" was to make MORE people buy crappy "insurance"

TOTALLY FUCKED UP

[slipslidingaway]

164. Well the insurance companies were losing customers, layoffs meant...

more people losing insurance. Also the insurance companies know that a large pool of their customers will be moving to Medicare beginning in the next year or two, they needed customers. Of course the insurance/drug companies had to play nice, they really feared a national system funded by taxes, good thing the Dems barred the door. :(


And Medicare saving will be used to subsidize some of the purchases of for profit health care - makes perfect sense.

If needed...
:sarcasm:

[Mimosa]

176. ^ Super accurate explanation of what happened to screw us ^ n/t

[slipslidingaway]

181. :) n/t

[Skittles]

178. YUP

all too obvious to anyone paying attention

[slipslidingaway]

183. Sometimes you wonder who lives in an alternate universe :) n/t

[Tansy_Gold]

226. No, not millions. And they will be able to GET, not AFFORD

the insurance.

"Afford" involves more than premium costs. As has been mentioned ad mauseam(pun intended) on this thread and others, it's the copays and deductibles and annual and/or lifetime limits. It's what is covered and what isn't.

People who have pre-existing conditions but are covered through their employers aren't eligible, and htey don't need to be. They're already covered. But as we've seen over and over and over in the past year or so, even those who are covered by employer-sponsored plans are seeing their coverages decline, their premiums and co-pays increase.

A person who isn't employed, or who is under-employed, and especially someone who is un- or under-employed because of their condition, simply can't afford the $5,000 or $7,200 premium on top of the co-pays and deductibles.

I'm almost 62 years old. I have three years before I'm eligible for Medicare. As a widow I get reduced social security benefits, and I have some income from self-employment. All told, my gross income is less than $20,000 annually. I have minimal debt, no mortgage, no car payment, just basic living expenses, car and homeowner's insurance, property taxes. There is no way in hell I could come up with $500 a month for insurance. I don't qualify for Medicaid, and I can't afford insurance. And I would be willing to bet there are more uninsured people in similar circumstances than there are uninsured people who are jumping up and down about how wonderful this new program is, how affordable it is, how much better their lives are going to be because of it.

It's not that there aren't any of those people at all. It's that to provide some benefit for a few people, many many more people are NOT benefited -- and the ones who benefit the most are the insurance companies, and they didn't need any more benefits to begin with.



TG, NTY

[pnwmom]

237. Yes, millions more. And at your income level you'll qualify

for substantial subsidies.

[scentopine]

124. The "sounds good to me" crowd are happy

because they've never had a serious problem or simply can't imagine that anything better is possible. The pols know that most people don't have cancer or debilitating illness so its easy for many people to say...

"at least its better than nothing"

as if they would passively accept nothing if it was offered.

They call this thinking pragmatic - "we'll at least I'm not living in a hut with a dirt floor, so I'm happy for that..."

There is no vision today, just bean counting. It will be our undoing, I promise. History will prove me right. Fear of the rich and powerful taking something away from us like health care is no way to live.

Access to health care isn't the same as demanding a 2500 sq ft house with 3 garages. Yet, that is how the debate gets framed. Likes its something only the "worthy" should have access to. Obama has done nothing to change that mentality, unfortunately.

I have zero respect for Gibbs after his cheap shot at "canadian health care". He seems better suited for fox news than the whitehouse.

[pnwmom]

129. Actually, it's the opposite. The people who have had cancer

or other debilitating diseases know how expensive they can be -- and that insurance for people with those pre-existing conditions has been far more costly until now -- if it was available at all.

[slipslidingaway]

136. You can have insurance and still lose everything, insurance does not mean ...

access to care.

[pnwmom]

193. It all depends on how much your "everything" is, obviously.

Obama's plan will help many fewer people to end up in that situation, however.

[slipslidingaway]

135. You are so right, there is no vision today about what could be...

too often people accept crumbs because who else are they going to vote for - the party that sucks less.

:(

I missed the Gibbs comment, we were in the middle of a month long hospital stay, but I must say I never liked the guy.

Thankfully we have The Google ...

http://articles.latimes.com/2010/aug/11/nation/la-na-gibbs-20100811

"These people ought to be drug tested," Gibbs said. "They will be satisfied when we have Canadian healthcare and we've eliminated the Pentagon. That's not reality. They wouldn't be satisfied if Dennis Kucinich was president."

Later in the day, Gibbs put out a statement saying he had spoken "inartfully."

"I watch too much cable, I admit," he said..."


Spoke inartfully, watches too much cable!

Guess the WH press secretary is just a low paying, insignificant position where you can vent your true feelings and be easily swayed.

:eyes:

[Name removed]

196. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Enthusiast]

211. "I have zero respect for Gibbs"

Me too.

[Skittles]

143. WTF???

IT'S NOT AFFORDABLE, THEN OR NOW

[pnwmom]

194. It's more affordable under the new pool than it was.

And when the program is fully operational in a few years, it will be more affordable than now.

[Riley133]

247. Not if you don't have a job.

$300-600 a month with a $1500 deductible might seem good to someone who is self-employed and making a decent amount of money, but if you're in the over 50 crowd and having to settle and be grateful for a job which pays
$11 an hour, this is still unaffordable.

The problem here is the definition of affordable.

[liberation]

165. Pssst.

50 yr olds with preexisting conditions are still not covered as of today.

Heck, even my sister who had a serious illness as a kid, and left her with a chronic condition CAN NOT GET INSURANCE RIGHT NOW AT A REASONABLE RATE because every single insurer uses her file as a "previous condition." She is in her 30s, and has actually a great advanced degree, with a good salary, which is the only reason why she can afford anything regarding her health care. Her tenacity and hard work, which led her to overcome her condition as much as she can... is actually her biggest handicap: she is not poor enough to be on welfare and apply for medicaid, and she is not rich enough to afford treating any possible complication out of pocket. What a fucking country!

And that is as of TODAY in California.

But who gives a shit, right? It is all about the Dems public image, what if the reform they passed is still shit. Since it does not affect any of you directly, it looks good... so let's run with it.

[amandabeech]

230. Okay. YOU pay $600 or so, live in the DC are and make $40,000 a year.

YEAH!! YOU!!!

YOU DO IT!!!

EITHER YOU DO IT YOURSELF OR YOU QUIT COMPLAINING THAT SOME OF US ARE HAVING A HARD TIME WITH THIS!!!!

[BzaDem]

92. Of course, you simply forgot to mention that this is TEMPORARY until 2014. That would go against

the narrative you keep trying to spread.

[kirby]

114. You are wrong...

Nothing magical in 2014 happens that makes the premiums affordable. It only allows people with pre-existing conditions 'access', not affordability.

[BzaDem]

127. Complete and utter bullshit.

No one making 400% of the poverty level or below will be paying more than 9.5% of their income for premiums starting in 2014. And people making less than 400% of the FPL will pay even less (down to 2% of their income, or free Medicaid).

[Riley133]

159. Where does it say that?

Please show me where in this document, because I can't find it.

http://www.healthreform.gov/about/answers.html

[liberation]

169. See the problem there is that you are believing your lying eyes...

... rather than just taking a tangential argument fueled by silly expletives at face value.

Repent sinner!

[BzaDem]

170. Just because it isn't in the document you posted doesn't mean it's not true.

http://www.csmonitor.com/USA/Politics/2010/0320/Health-care-reform-bill-101-Who-gets-subsidized-insurance

"The formula is pretty complicated. Basically, though, people who make three or four times the poverty level would get enough federal money so that they would not have to pay more than about 10 percent of their income for a decent health insurance package.

People who make less would have to pay a smaller slice of their income for coverage. For instance, individuals who make about $14,000, and four-person families with incomes of about $29,000, would not have to pay more than 3 to 4 percent of their incomes for insurance.

And those who make even less – under 133 percent of the federal poverty level – would be able to enroll in a newly expanded Medicaid program."

[Riley133]

248. OK, but what about the rest of us who make over $15K a year? nft

[dflprincess]

174. Currently, 400% of the poverly level for a single person is an annual income of $43,400

9.5% of that is $4,123/year or $343.58/month. That's just the premium - nothing tells us what kind of "coverage" a person could get for that and if they will actually be able to afford care or if they'll just be helping to line the pockets of insurance executives with their premiums.

I do know my brother's COBRA payment is $397/month. For that he gets a $2,000 deductible and once that is met, he has an 80/20 copay until he has run up another $1,500 in out of pocket expenses.

This isn't is a "health care" act. It's an insurance bail out.

[BzaDem]

185. "nothing tells us what kind of "coverage" a person could get"

You don't know, because you close your eyes to facts and truth.

But that doesn't mean people who are not so closed minded don't know. In fact, the coverage a person would get is RIGHT IN THE BILL. The government MANDATES that all plans cover what the government wants them to cover. It MANDATES that the actuarial value of the plans be above a minimum (which limits copays and deductibles). It MANDATES that all preventive care must be FREE, without any copays or deductibles.

The only reason you don't know is because you choose to be ignorant.

[dflprincess]

190. Preventative care is not "free" it's included in the price of the premium

And much of what is called "preventative" is actually screening tests that might catch a problem early but don't acutally prevent anything. These tests don't do you a whole lot of good if you can't afford any needed follow up- which is not "free" and it can cost several thousand dollars to find out that funny spot on the mammogram is benign.

Yes, there are some mandates about what is and is not covered but the insurance companies still have a lot of leeway about what kind of coverage they offer. Two of the big things missing from the insurance bill are any mandates for adult dental or vision services. And you are delusional if you think the insurers won't find a way around the mandates especially as there are no real penalties for doing so (though I recall the bailout bill did spell out very cleary what happens to anyone who lies to the insurance companies about their health or to the government about their income).

It is not those of us who know that buying an insurance policy does not guarantee access to care who are ignorant.

[BzaDem]

191. If insurers violate the law, states can kick them off the exchanges entirely

which would cost them access to a pool of tens of millions of customers.

[Riley133]

251. And states are NEVER known to turn the other cheek

when it comes to business deals.

[kirby]

243. So what?

I make over 400% of the poverty level. Me and everyone else in that LARGE group shouldn't be able to have affordable coverage?

[another saigon]

94. like the banksters and politicians of all stripes

they are parasites on the voiceless majority.

:cry:

[GETPLANING]

102. Advanced countries price healthcare as a cost-

They know what it costs to keep their populations healthy and care for the sick. It is figured into the annual budgets and appropriate revenue is raised to cover the cost. No more, no less.

America prices healthcare as a RISK- and calclates a premium for that risk. If the cost of covering that risk turns out to be less than the actual costs of care, well, that extra money just gets paid out to shareholders and executives. That's why America pays twice what the ROW (Rest of World) pays, and still has people dying every day of neglect.

[madbee9]

111. Sad facts about health insurance

Unfortunately that is as bad as many policies without a pre-existing condition For many people working in smaller companies prices are very high. Our last policy had a 30% co-pay! It went up 50% so the company switched to a policy with a $2,000 deductible, but for a couple it is $4000 before they pay anything for either of us. There is no co-pay for doctor's visits, etc. The deductible is $12,000 if the providers are out of network. No drug coverage. My husband pays in over $400 a month and his employer pays some.

I'm glad they took off the lifetime cap so people with insurance won't lose everything.

[Snarkoleptic]

115. Sounds better than the group plan my company had through their PEO.

The plan conditions cost me $7,200/ year and had a $5,000 deductible.
Granted this covered myself, wife and son (the example was a single male).
Naturally my bride blew right through the deductible with an ER visit in February.
I got laid-off a month later and had to pick up COBRA for the same coverage at $1,400/mo.
This was through a carrier called Harrington Health...WTF is that? May as well be called Joe's health insurance.

Anyhow, my wife had a little touch of cancer (sarcoma) back in '02 (cancer free for 8-years!).
When the COBRA payments exhaused savings we went through a series of catastrophic-only plans that have more holes than swiss cheese.
Each time we had to go back to our prior carriers and get a "letter of creditable coverage" to show that we had no gaps in our coverage. To have a gap in coverage would have allowed subsequent carriers to exclude her sarcoma as a pre-existing condition.

I'm about to qualify for 'real' coverage through my new employer on 10/1 and couldn't be more pleased. I have had bullshit coverage for 3 1/2 years and can tell you from personal experience that it's a MASSIVE financial/emotional drain.

Never heard of a "letter of creditable coverage"? Neither had I before being fucked around by the system for the past few years.
The LOCC requirement and preexisting condition exclusions always seemed like the carrier was lying-in-wait for me to slip up and lapse coverage. Glad that BS is about to end for me.
<rant/off>

[Egnever]

116. So dont get it

:shrug:

If you need it it seems like a pretty good deal. Could be better but it dwarfs having nothing and hitting the $2500 could be done in a matter of days by many that would use this.

[kirby]

122. So you support the Repuke plan of 'Die Quickly'?

Yeah, I agree, the OP just should plan on not getting sick. Or if he is going to, he should bankrupt himself with premiums so he is covered.

[liberation]

167. Funny, ain't it?

when you follow the logic of some "moderates" , its ultimate consequences start looking very "reactionary."

Ain't that a bitch?

[Techn0Girl]

199. Hell NO! I Support the Dems Plan of "Pay Up!"...

The Repukes plan is stupid!
If you're dead then you can't pay off your debt to the HMOs.

[mzmolly]

120. Doesn't the actual plan go into effect in 2014?

:shrug:

[kirby]

123. Yes, but...

Nothing magical in 2014 happens that makes the premiums affordable. It only allows people with pre-existing conditions 'access', not affordability.

[mzmolly]

152. The bill contains subsidies,

though.

[bvar22]

126. 2014 is when the real bomb explodes.

That is when 40 Million Americans will be herded into the Exchange Pens where they will be forced to BUY Insurance they can't afford to use.
THAT is going to be a disaster that will make Democrats unelectable for a generation.

ALL the Republicans have to do is sit back and say, "Yep. We opposed it."

The smartest thing the Democrats did was to postpone the Exchange Pens until AFTER the 2012 elections.

The Republicans are scheduled to assume token power in 2016 anyway under the two party power sharing agreements.

[BzaDem]

128. Your mistaken assumption is the idea that people won't be able to afford to use their insurance.

15 million of the 31 million will get Medicaid. I'm waiting for your explanation how they won't be able to afford something that is free.

The remaining 16 million will get private insurance that have MANDATED minimum actuarial values, which LIMIT the amount of deductibles/cost-sharing/etc they can have. People making up to 200% of the poverty level will even get their deductibles/cost sharing heavily subsidized.

Your posts about this are just bullshit talking points. They don't ACTUALLY reflect reality.

[leftstreet]

132. Please don't refer to Medicaid as "free"

That's such a rightwing talking point

:-(

[uncommon]

227. It comes at no out of pocket cost to the insured using it - to the person

receiving Medicaid, that very much means it is free for them to go to the doctor.

[bvar22]

179. Your mistaken assumption ...

is that MILLIONS of Americans are going to be happy about being forced to buy Crapsurance.
The "MANDATED minimum actuarial values" are already being gamed according to Wendell Potter.
Partial Subsidies (Direct Corporate Welfare) are still going to require "out of pocket" money from people who don't have pockets.

I applaud the increase lowering of Medicaid eligibility, but we didn't have to eat the whole Shit Sandwich (Mandates without a Public Option) to get that.
Increasing Medicaid could have been passed with a single, clean bill.
So could PECs and criminalizing dumping.

To fully appreciate how BAD the HCR bill really is, simply compare it to what is taken for granted in every other civilized country in the WORLD.
Do you know that "Medical Bankruptcy" is a term unknown in civilized countries.
"Medical Bankruptcy" will STILL be Big Business in 2014.

We will see.
History is on my side.
On your side????...wishful thinking, Trust in the Health Insurance Industry, and Hope.
God help us all.

[BzaDem]

184. If history were ACTUALLY on your side, HCR wouldn't have failed every time it was proposed

since Truman, until now.

You also neglected to mention that Wendell Potter supported the bill. If you are going to bash the bill, you probably shouldn't use someone who wanted the bill to pass.

"are still going to require "out of pocket" money from people who don't have pockets."

Oh yeah. No one has pockets. Unless Single Payer is proposed by PHNP, which would institute a 7% payroll tax and 2% income tax. NOW everyone all of a sudden has pockets.

:rofl:

"So could PECs and criminalizing dumping."

That's crap. You can't ban denial of care based upon pre-existing conditions without a mandate. It has been tried in New York state, and their premiums are thousands of dollars every month. Their individual market went from 700k people to around 30k people.

Compare that to Massachusetts, which has a mandate, and 97% of its citizens are insured. Premiums dropped by ~40% when the mandate went into effect.

Oh, sorry. I'm using facts and numbers, and you don't like that. You would rather wallow in your made up narrative.

[bvar22]

187. Using RomneyCare as your model for success?

I'll see your :rofl:
.
.
and raise you a :rofl:

[BzaDem]

189. Sure. People in liberal Massachusetts overwhelmingly do not want to go back to preRomnycare, and 97%

of its citizens are insured. The bill is called Romneycare, but it actually was written by a state legislature that was 8-1 Democratic.

Could they have done better than Romneycare? Sure. But that doesn't answer the question of whether Romneycare is better than the jungle that was the status quo. What DOES answer the question is the people of Massachusetts, who overwhelmingly think you are FULL OF SHIT.

[mzmolly]

150. One can opt out for a maximum

of 50 a month until they need coverage, to my understanding.

[DebJ]

125. How about paying that without a pre-existing condition? My

husband can't retire at 62, like he should be able to after 29 years of teaching, unless I get a job with benefits, because it would cost us $24,000 a year + deductibles for insurance for the both of us. It is a top of the line plan, but it is also the only option available. His pension (without SS for several years) would be only $40,000 a year. Since we're a good ways off from paying off the mortgage, we would only be able to pay mortgage and health care, no food, no utilities, no car insurance....

And this doesn't take 'pre-existing' into account.

[leftstreet]

134. K&R

Thanks for posting this

[Skittles]

142. "AFFORDABLE HEALTH CARE"

:rofl: OMG WHO DO THEY THINK THEY ARE KIDDING, besides a certain segment of VERY STUPID DUers?

[Mimosa]

239. ^ LOL @ Skittles comment ^

Skittles, do you think the cheerleaders genuinely believe the BS they post? I don't. Because we who have studied the health care/health insurance issues for 20+ years keep referring them to the facts and they ignore the facts.

[Lucian]

144. But it was a REFORM...which was a BFD....

:eyes: :eyes: :eyes:

Didn't do shit for us with preexisting conditions. Just made things worse.

[Liberty Belle]

177. Agreed. I just got turned down for insurance; Obama, are you listening?

because I had the audacity to see a chiropractor for occasional relief from aches and pains caused by an accident 12 years ago! Never mind that I never asked my insurer to pay for these services, which I get free in trade-out for other services that my business provides to the chiropractor!

I am so mad I can hardly see straight. Ironically this is the same company that's been insuring me for years; i'e been on COBRA benefits but am losing it because my husband changed jobs. His new company has a horrible HMO where two doctors committed malpractice on me before. I am scared to death of being forced back on that plan.

Blue Cross is the plan that turned me down. Cherry picking is really out of hand.

I have no degenerative or serious conditions, other than the back injury, which is not treatable surgically and can only be relieved with occasional chiro or massage treatments.

They told me to get insurance I'd have to have zero treatment for a full year AND prove that the nerve paralysis is gone - an impossible feat, so I'm screwed.

This is NOT the healthcare reform I voted for, Mr. President!

[demodonkey]

192. I had Blue Cross; they "lost" my selfpay premium check one month and cancelled me for non payment...

...then wouldn't let me reinstate (except a unaffordable cost) because I too had seen a chiropractor on my own dime.

That was in 1995. I STILL have NO HEALTHCARE.

:grr:

[Riley133]

253. Long shot, but did you try the state agency which oversees insurance?

I'm found them to be helpful in the past, and they do collect data which I would like to think ultimately helps us in the run - though I could be wrong about that.

TRULY AFFORDABLE SINGLE PAYER NOW!

[lillypaddle]

197. My premium is $7200 a year

and I have a $5,000 deductible without a pre-existing condition. I'm 62. FWIW.

[Mimosa]

241. Is that Medicare? n/t

[lillypaddle]

245. No, it's BC/BS

I'm not eligible for Medicare until I'm 65.

[JournalistKev87]

198. Oy, my Type 1 'beetus

is gonna bite me in the ass.

[mmonk]

214. Even that is an improvement over what I pay out of pocket.

However, it isn't exactly reform I was looking for.

[sam sarrha]

215. our Union got us. $500 deductible, $250 spouse, $1000 out of pocket, plus they took our 3% annual

raise and 3yr..5yr bonus and put them in an account to pay the extra cost of the premiums.. $1000 out of pocket, 500 for spouse. we wont get a raise for 5 years. they take out life insurance on us too, our company is growing leaps and bounds, they are cutting out tac times 20% and slave driving us into the grave.

[scentopine]

228. Funny how the right wing in both parties is anti-worker, they trumpet

the goodness of corporations who collectively bargain with Obama and his legion of wall street shit heads who control policy - they give us "health care reform".

Grrrrrrr.

But a bunch of non-union workers collectively bargain - well that's just communism. Then they'll accuse us wanting a single payer system. God forbid.

As long as we keep electing centrists and right wingers (be they democrats or republicans) things are getting worse.

Our company is CEO is doing great with salary and bonuses at record high. Every time the stock goes up they get bonuses. They have every incentive to make the stock pump up and down because each gyration lands cash in their pocket.

The CEO is so lame (and the profits are high) that after laying off hundreds, they opened a new center in India and asked us to welcome our new colleagues!

As a cost cutting measure we empty our own trash and do our own workspace cleaning. That is how an MBA thinks.

Obama is screwing up. Rahm et al continue to gamble that good will alone toward Obama will carry him through mid-terms and into a second term. That's why they are comfortable telling many of us to shut the fuck up as they feed the corporate pigs at the trough.

It troubles me to see anti-union professionals slaggin off, until their ass in on the street and they are bankrupt. People respect wealth - they slit their own throats in order to protect the gilded class of robber barons selling the country to Asia for pennies on the dollar.

We won't be made whole intil there is an end to outourcing.

[femrap]

217. Instead of the DNR,

just give me the KMN (Kill Me Now).

[uncommon]

221. I am perfectly healthy and my deductible is $3,000.00. And the coverage costs

about $6,000.00 a year.

[emald]

229. me too, I'm part of the herd of pony lovers who have been dissed

No one can afford this shit for insurance. Insurance is not health care. That change thing isn't so changy now, is it?

[and-justice-for-all]

234. Only in America...nt

[EFerrari]

242. My consolation is that if I have a pre-existing condition it will kill me

because I won't be DXd in time to know about it.

[Riley133]

254. Agreed - just talked to a group about this

Everyone over 50, everyone dropping insurance due to costs, everyone planning on an early death because even if we do have something, by the time we get to the ER it will be too late.

Party it up now. There will be no golden years for us.