Are You Sure You Actually 'Like' Your Private Health Insurance?

If McDonald’s told us that 71 percent of their customers said their food was healthy and nutritious, we’d be reasonably skeptical at the very least.

I love my Medicare Advantage Plan through United Health Care.

The problems that remain with "Medicare For All" or single payer, or whatever you want to call it...

is that it still won't be free and some states will likely extend it to cover illegals and their kids and extended families.

Like any type of socialized health care, it probably will not cover a lot of conditions, situations, or experimental procedures.

Since the government will try to keep costs in line, care at times might be limited, rationed, or even denied.

Thanks to lower payments to providers and hospitals, lots of doctors may retire, not accept Medicare patients, or establish "pay for service" practices. Wait times for appointments and procedures will likely increase. To reduce costs, hospitals will likely try to discharge patients as soon as medically possible.

And no one has of yet come up with a solution of who will pay for it all.

I have excellent health coverage which is provided by my employer.  Got me through a serious illness of cancer without any financial burden.

I was able to have the best surgeons, chemo, and radiation doctors and treatments in my area.  

I am very happy with my health coverage and do not want to lose what I worked for and earned for many years because of being forced into socialized medicine.

Socialized medicine actually gives you the same thing and cost less for everybody, including the employers.  I don't think a lot of Americans really understand national healthcare.   It is just like what we have (in the 2 countries I lived in), except it is free or costs much less.  By free I mean not paid out of pocket, its part of your taxes.    You still get great care, I never once had a bad experience, and had less waiting than I do here.  There are some appointments you can't even get for 2 months here!  My daughter had 2 surgeries overseas, excellent care both times.  Multiple doc appts, no problem.  House calls?  Ok, that was a while ago, but had it in Ireland back in the day, long after they stopped here.  We have good healthcare now that has translated into retirement coverage (thank you UNION).  But if the US had a better healthcare system,  we would all be covered and it would cost far, far, less.  There are so many models to choose from, it would be nice if we could start and see how ours can be better using the experiences of other countries throughout the world. US employers already pay too much, and its part of the reason salaries are so low, plus we now share far more of the cost of treatment.  There are better ways.

Socialized medicine actually gives you the same thing and cost less for everybody, including the employers. 

Really?  How is that?  Who is paying for it?

There are some appointments you can't even get for 2 months here!

I have never had to wait 2 months for any appointment/procedure/treatment in my entire life for myself or my family.  I don't know anyone who has unless it is with the VA.

US employers already pay too much, and its part of the reason salaries are so low, plus we now share far more of the cost of treatment.

Do you know why employers pay so much?  Because the cost of Obamacare was passed on to them through taxing mandated by Obamacare.  And those expenses are passed on to the employees.  I am in a position where I can bargain for my insurance to be paid for but not all employees can.

I have excellent health care and insurance, and I plan on keeping it that way.  And my children do to because they have worked for it.

Don't libs want people to stay out of their health care, well stay out of mine.

Like I said, Sunny, information is your friend.  Instead of continuing to defend a healthcare system that is declining,  there are ways to improve care and cost.  But continue to live in your bubble (which I also inhabit, by the way, with good benefits).  Its not enough for the the future, and likely won't last out from retirement to death if previous healthcare promises are an indicator.  This has nothing to do with 'working for it'.   Don't know why some people have such a problem seeing things outside their personal lives.   And by the way, my 2 month wait is NOT the VA, and not unusual for this medical department. 

Do you know why employers pay so much?  Because the cost of Obamacare was passed on to them through taxing mandated by Obamacare.  And those expenses are passed on to the employees.  I am in a position where I can bargain for my insurance to be paid for but not all employees can.

Wrong.  Obamacare began containing prices.

statnews

In 2017 alone, health expenditures were $650 billion lower than projected, and kept health care spending under 18 percent of GDP — basically a tad over where it was in 2010 when the ACA was passed. It did all of this while expanding health coverage to more than 20 million previously uninsured Americans.

Compared to the 2010 projections, the government’s Medicare bill in 2017 was 10 percent ($70 billion) less, and spending for Medicaid and the Children’s Health Insurance Program was a whopping $250 billion below expectations (partially — but only partially — due to the failure of some states to expand the program). The actuary had predicted in 2010 that employer-sponsored insurance would cost $1.21 trillion in 2017, but it came in at $1.04 trillion, a difference of $170 billion for that year.

Put another way, health care spending in 2017 was $2,000 less per person than it was projected to be. And for the 176 million Americans who have private employer-sponsored insurance, their lower premiums averaged just under $1,000 per person.

Barack Obama pledged on the campaign trail and as president that he would sign a health care bill that lowered family health insurance premiums by $2,500. Conservative politicians and pundits roundly mocked him. Yet the ACA has more than delivered on that promise, saving about $4,000 per family. And these lower health care premiums probably contribute to the recent rise in workers’ wages .

One reason the ACA’s enormous success in cost control goes unappreciated is that no one experiences the difference between projections and reality. What could have happened is intangible. All we feel is what actually happens.

Informative articles below.

cnn

insights.som.yale

theguardian

The United States spends twice as much on healthcare as 10 other high-income nations, driven by the high price of everything from prescription drugs to doctors’ salaries, a new study in the Journal of the American Medical Association finds.

Recent attempts to reform American healthcare have assigned blame for the high cost of care to nearly every sector – from drug companies to hospitals to health insurers .

However, a co-author of the new study said those arguments ignore the “800-pound gorilla”: sky-high prices everywhere.

“Most countries get to lower prices one of two ways: they either have a very strong price setter, usually a government agency, or more efficient markets,” said Dr Ashish Jha, co-author of the study by researchers at Harvard’s TH Chan School of Public Health . “The US has figured out how to do the worst of both.”

In the study, America was compared to 10 other countries: the United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, Denmark, the Netherlands and Switzerland.

Researchers used 98 indicators to compare countries across seven areas: general spending, population health, structural capacity, utilization, pharmaceuticals, access and quality and equity. The majority of the data came from international organizations, such as the Organization for Economic Cooperation and Development. What researchers found was not a single sector with high prices, but that every sector had extraordinary price tags.

For example, the average salary for a general practice physician in the other countries was between $86,607 and $154,126. In the US, the average salary was $218,173.

Per capita spending for prescription drugs in other nations ranged from $466 to $939. In the US, per capita spending was $1,443.

The US also spends more on administrative costs. Other nations spend between 1%-3% to administer their health plans. Administrative costs are 8% of total health spending in the US.

This results in US health costs that, as a percentage of gross domestic product, are nearly double that of other nations. In 2016, the US spent 17.8% of GDP, compared to 9.6%-12.4% in other countries.

At the same time, America often had the worst population health outcomes, and worst overall health coverage.

The US ranked last in life expectancy; had the worst maternal mortality rates (nearly triple that of the United Kingdom); more infant deaths than any other country, and a high rate of low birth weight babies

Other countries had universal, or near universal, health insurance rates. The US ranked last. Just 90% of Americans have health insurance, leaving about 27 million people without access to healthcare.

Advertisement Jha said whether the US moves toward more private healthcare , as advocated by Republicans, or to single-payer healthcare , as advocated by liberal Democrats, price tags on all American health services need to be addressed.

“I’m happy to move in either direction that will allow for lower prices, but right now we’re not even having that debate,” said Jha. “We’re fighting over all sorts of other things.”

The study’s possible weaknesses include comparability of data, with different countries having “modest” differences in data collection.

Barack Obama pledged on the campaign trail and as president that he would sign a health care bill that lowered family health insurance premiums by $2,500

Where is my $2500.00?  Insurance premiums have increased under Obamacare. 

Yes, information is your friend.

money.cnn
investors
freebeacon

And by the way, my 2 month wait is NOT the VA, and not unusual for this medical department.

Where was it?

And don't call me Sunny unless you mean it in a kind way and I don't think you did.

And don't call me Sunny unless you mean it in a kind way and I don't think you did.

Actually I didn't mean it in a bad way and you would know if I did (I didn't think sunny was a bad nickname),  all I want to do is have a debate about healthcare reform.  You dismiss my 2 month appointment wait, and I am living it, my appointment isn't until August when I won't even be living here any more.  We have a great plan with great coverage, $5 co pay (and not Kaiser, its a great PPO).    Why is it so hard for people to understand the reality of others experiences?  I'm blunt and I try not to say things to people that they can't take.  I guess I thought you exhibited the same tendencies here.  This subject is at the top of my priorities and I'm really passionate about it.  When I read yours and other posts here, they are also blunt and sharp.  Sounds like one of those 'dish it out but can't take it' moments to me.  And we can't really have a debate about the broader topic of reform if everything is seen through a personal experience with no understanding of others experiences. 

And we can't really have a debate about the broader topic of reform if everything is seen through a personal experience with no understanding of others experiences. 

That is the topic of the seed. You are using and talking about your personal experiences.   Why wouldn't I talk about how it effects myself and my family isn't that what others do? Why shouldn't I protect what I have worked for?  Do you think you should just be able to come along and take something from me and replace it with something that is inferior and then want to tax me more for it? What right do you have to do that? 

I stay out of others health care so you can just stay out of mine.

I stay out of others health care so you can just stay out of mine.

No, you don't.  You want to restrict a woman's right to choose.  At least be honest here.  

You want to restrict a woman's right to choose.

I do?  If you are going to make a false statement you better dam well back it up.  Go through all my comments and let's see what you find....you will find just the opposite.

Yeah, let's be honest here.

Socialized medicine actually gives you the same thing and cost less for everybody, including the employers.

Until you actually do the math.  It will definitely cost less for employers.  They currently spend about $1trillion/yr on it, and that will go nearly to zero.

They'll need to double total income tax revenue in order to pay for that bullshit, and Bernie's ideas about how to do that are the equivalent of rounding up unicorns that shit cash.  Believing they can pay for this by soaking a handful of billionaires requires lower math skills than Winnie the Pooh.

I am very happy with my health coverage and do not want to lose what I worked for and earned for many years because of being forced into socialized medicine.

What do you fear would be taken from you if we had universal healthcare coverage? 

I always wondered that. It is one thing you would think most people would be for, instead of lining insurance company pockets.

Yet it seems most people believe the doom and gloom, that it would end healthcare, socialism, blah blah... I still think it boils down to the 'I got mine screw you' attitude. They think they are paying for everyone else, even though everyone would pay into the system.

I am always amazed that people would willingly pay a grand a month for insurance yet universal healthcare? No way.

Obamacare death panels.....

always wondered that. It is one thing you would think most people would be for, instead of lining insurance company pockets. Yet it seems most people believe the doom and gloom, that it would end healthcare, socialism, blah blah... I still think it boils down to the 'I got mine screw you' attitude. They think they are paying for everyone else, even though everyone would pay into the system.

Many people do not appear to understand how the basic concept of insurance functions. It is not a savings plan for a single person. It is money from a wide spectrum of people pooled together to limit the financial costs to any group in that plan. The more people you have in the pan the cheaper the individual costs are.  We must also end the idea of insurance companies making a net profit from coverage or allowing them to make medical decisions as a way to limit coverage costs. 

I am always amazed that people would willingly pay a grand a month for insurance yet universal healthcare? No way.

Universal heathcare isnt going to be free, but it will be cheaper than the current system for most people.

The idea of insuce companies making a net profit on healthcare is relatively recent. 

For-profit insurance companies moved in, unencumbered by the Blues’ charitable mission. They accepted only younger, healthier patients on whom they could make a profit. They charged different rates, depending on factors like age, as they had long done with life insurance. And they produced different types of policies, for different amounts of money, which provided different levels of protection.

Aetna and Cigna were both offering major medical coverage by 1951. With aggressive marketing and closer ties to business than to health care, these for-profit plans slowly gained market share through the 1970s and 1980s. It was difficult for the Blues to compete. From a market perspective, the poor Blues still had to worry about their mission of “providing high-quality, affordable health care for all.”

In 1994, after state directors rebelled, the Blues’ board relented and allowed member plans to become for-profit insurers. Their primary motivation was not to charge patients more, but to gain access to the stock market to raise some quick cash to erase deficits. This was the final nail in the coffin of old-fashioned noble-minded health insurance.

These same people also gladly accept Medicare, VA benefits etc.

The sad thing is, insurance companies actually had what I would call death panels.

It is money from a wide spectrum of people pooled together to limit the financial costs to any group in that plan.

I had someone argue that it doesn't work that way. It didn't matter how many people were in the pool, on and on. I could only shake my head.

When a for-profit is faced with the choice between spending money to treat patients, or to pay dividends to shareholders...

I had someone argue that it doesn't work that way. It didn't matter how many people were in the pool, on and on. I could only shake my head.

This is a concept that they should have learned in a high school life skills course. 

How it works

When you buy a policy you make regular payments, known as premiums, to the insurer. If you make a claim your insurer will pay out for the loss that is covered under the policy.

If you don’t make a claim, you won’t get your money back; instead it is pooled with the premiums of other policyholders who have taken out insurance with the same insurance company. If you make a claim the money comes from the pool of policyholders’ premiums.

abi.uk

I don't want the government involved in my healthcare.Some have the attitude you got yours and I want yours. 

Who exactly are these people that you are referring to? Is that the way Medicare works?

I'd rather not have a private for-profit insurance company who is more interested in net profit and shareholder returns than my health to be involved in my healthcare or my medical decisions.  I also don't want pandering politicians who seek to further their conservative beliefs involved in my medical decisions.

That is a silly statement. What you "want" is immaterial. Government is involved in all aspects of your healthcare already. From what insurance companies cover and what they don't to the professional standards of caregivers to the drugs you are allowed to take government is involved,..

Being a country boy at heart (even though I now live in a small city) I'm very aware of how badly rural America is when it comes to health care and access to health care.

Fact - 49% of rural Americas cannot afford a $1000.00 emergency. 

Fact - Over 20% of rural health care providers are on the brink of closing - 36% of the hospitals in Alaska, Arkansas, Georgia, Maine and Mississippi are in financial jeopardy. 

Fact - Only 59% of workers in rural areas are offered employer-sponsored health insurance. On average, individual market plans cover 63 percent of medical costs, compared to 75 percent covered by group insurance plans.

Fact - The rural privately insured are over 50 percent more likely to have no drug coverage.

Fact - Rural Americans are more likely, on average, to have poorer health than those living in urban areas.

Gee...

Maybe somebody should do something.

President Trump’s base is largely rural, so I'm sure he will propose improvements to the ACA to resolve these problems...

Maybe somebody should do something.

That would require bipartisan work. We are too busy being divisive.

President Trump’s base is largely rural...

As some of my family reminds me too often.

I'm sure he will propose improvements to the ACA to resolve these problems.

He did say the GoP will be known as the "party of great health care", but we can't know what it is until he get's re-elected. /s

He did say the GoP will be known as the "party of great health care", but we can't know what it is until he get's re-elected. /s

Kinda like having to pass Obamacare before we know what's in it.

Hell, I am still waiting for my mythical $2500 savings we were promised!

What's a few more years, eh?

What's a few more years, eh?

Still waiting too.  One of Obama's many broken promises.

It was released 14 months before it was passed, how much time did you need? 

Hell, I am still waiting for my mythical $2500 savings we were promised!

It was based on participation...the more people that use it, the cheaper it got. Don't blame Obama because your party has a bunch of rednecks too stupid to figure it out. 

Don't blame Obama because your party has a bunch of rednecks too stupid to figure it out. 

It was released 14 months before it was passed, how much time did you need? 

Ask Pelosi....she said it had to be passed before she knew what was in it.  

It was based on participation...the more people that use it, the cheaper it got. Don't blame Obama because your party has a bunch of rednecks too stupid to figure it out.

That remains one of the stupidest things foisted on the American public.

Like adding millions of services is going to make them cheaper somehow.

Millions more are participating--but I don't see my costs going down.

That remains one of the stupidest things foisted on the American public.

No, that would be Trump.

Millions moreareparticipating--but I don't see my costs going down.

When Trump and the Republicans killed "the mandate" it added 20% to your premium.

Maybe somebody should do something.

Maybe they should move.

I am perfectly happy with my health insurance situation. I have Medicare A&B as primary and TriCare for Life as my secondary. I pay a annual premium of $1,000.00 per year with zero out of pocket expenses except for about $40.00 per month in prescription costs. Now all the above was not free. It comes from 20 years of honorable service in the United States Navy in two wars and shed my blood on two continents. I firmly sympathize with those that are not as fortunate as I am but life is like that sometimes.

Now all the above was not free. It comes from 20 years of honorable service in the United States Navy in two wars and shed my blood on two continents

Thank you for your service Ed.

I do need to point out, however, that you have Medicare because you turned 65. You likely had the VA before that in exchange for your service, but you have Medicare because you and every other tax paying American has been paying into the program. Some believe that's a pretty good idea and think if they pitched in more now (paying insurance premiums into Medicare instead of to some private health insurer who spends 14% on overhead and profit vs Medicare that spends 1%) that they could buy into Medicare early. I don't see why that kind of Medicare option would be a problem, it wouldn't ban private health insurers, though it would likely create some competition that could drive down even private health insurer premiums.

Actually, I have SSDI with Medicare due to service connected disabilities that prevented me from working a regular job, not because I turned 65. I am actually 64 and have had it for the last 6 years. Va did not become a option until about 10 years ago due to the fact that I was retired military. I had to wait for the VA to rate me at least 40%. I have since had that disability rating raised to 90%. I agree with what you said about the Medicare options.

service connected disabilities

A little off topic but...would you believe I have been trying to get that since 1991?

I hear you. It took me ten years of fighting the bureaucracy tooth and nail to get it. I tried it on my own for a couple of years, then went through a veteran's advocate group before I was successful. Best advice I give vets is to get a lawyer and let them fight it for you.

Best advice I give vets is to get a lawyer and let them fight it for you.

You have to go through the cost of getting a lawyer now to deal with the bureaucrats?  Yeah, that is what we want more of.

Actually, you are mistaken. Most VA advocacy groups charge you nothing unless you win. Then they collect between 20 to 30% of your lump sum award as their fee.

20 to 30% of your lump sum award as their fee.

Well that sounds like a cost to me.  Where am I mistaken?

I suppose that depends on what you consider the cost of getting a lawyer is. Most lawyers charge a fee just to talk to them. Then you are responsible for court cost fees. Then there is also a percentage of the ultimate award. Most VA advocacy only ask for a percentage of the lump sum award.

I suppose that depends on what you consider the cost of getting a lawyer is.

That is great that you get help for some of the cost, but I would consider any out of pocket expenses to be cost.

It is a shame that you had to hire a lawyer and pay to get the benefits that you have earned through your service.  I would not want anymore of that treatment in our health system for people to get their care.  

I just cannot help but bet the impression you have never served in the military have you?

I just cannot help but bet the impression you have never served in the military have you?

What does that mean and why does it matter?  No I have not, but my father served in the early fifties, my uncle in WW2 , my grandfather in WW1 (he died later at Jefferson Barracks in St. Louis), two other uncles in Vietnam, one a marine and one an army cook, another uncle on my mother's side was air force.

I don't understand why you are asking.  Are my comments offending you somehow?  If so, that was certainly not my intention.

Government should be disallowed to have any involvement in healthcare.

i refused to sign up for Medicare when I turned 65 even though I was forced to pay into it since it began in 1965

this is just about more totalitarian government control over our lives.

this is just about more totalitarian government control over our lives

I doubt many actual Medicare recipients would agree with you. They likely understand that it is a necessity they couldn't live without. The fact is, in the last hundred years Americans life expectancy shot up creating a whole class of elderly that almost didn't exist before social security and Medicare were formed.

"From the 1500s onward, till around the year 1800, life expectancy throughout Europe hovered between 30 and 40 years of age . Since the early 1800s, Finch writes that life expectancy at birth has doubled in a period of only 10 or so generations . Improved health care, sanitation, immunizations, access to clean running water, and better nutrition are all credited with the massive increase.

The health insurance companies we have now have proven to me that they can't or won't do what is needed.  They try very hard to get out of paying for things

The health insurance companies we have now have proven to me that they can't or won't do what is needed.  They try very hard to get out of paying for things

You've obviously never dealt with the VA, strictly a government agency.  They try just the same to get out of paying for things and, unlike health insurance companies, they have armed force to back up their "no".

Yep, health insurance companies (every one of them licensed by the government) do give crappy service.  Government run health care is worse.