Deleted thread 3

Deleted. I can’t delete others posts, but I can delete my words in the initiating threads.

Then you will purchase coverage from your state risk pool. I had this exact thing happen, it was the best insurance I have purchased in the last 20 years.

I am freaked out too. We have fabulous insurance through my husband but he assumes that will always be the case. And sticking with this requires us to live in the hyper expensive Bay Area for the foreseeable future, even with all of us crammed like sardines in a two bedroom one bathroom.

My company’s insurance is much more austere – and as I’ve been working at this place for a while I’ve seen how the requirements and provisions in Obamacare have actually increased the generosity of the plan they procure for us, so I think that’s more typical in this country and I have no doubt my company would walk back benefits if they weren’t legally obliged. I’m also worried that employers could bring back lifetime caps – my past insurance did have those caps around 100k or 200k. That would be five or six years of treatment for Samson :(.

Honestly, I’m willing to move to another country if that happens. Lately I’ve just been feeling pretty depressed thinking we live in a country where we have so much money and yet we want to treat the most vulnerable people with so little care. It’s not just our personal well being; I’ve been feeling like even if we can scrabble out an okay existence, the fact that the system is just so mean has really disenchanted me.

@Chris, what state do you live in? In my experience, these risk pools were not viable, had long waiting lists – apparently only a handful of these were actually able to provide coverage for everybody who needed it. And on top of that, they are not being adequately funded in the house bill so even if in theory they could be viable, they will quickly crumble under the weight of people who need care that the states cannot provide (no idea on the Senate because they have not released any details on a bill they will pass next week)

Oregon. I applied, showed my denial letters, and had insurance within one week. Because our income didn’t qualify for any help, it was expensive, but it was so good in that there were no co-pays at all for routine office visits or long-term medications. The insurance program was cancelled when the ACA passed, otherwise I would still have this insurance.

interesting. I joined the Washington state health insurance prior to ACA but had to wait a while to get on it, and it was very bare bones – yes they paid for preventive care and some office visits but it was HMO-style, so everything had to be approved and vetted through your primary care provider. They didn’t cover a lot of treatments.

That wasn’t high risk though. It was certainly much much worse than our current insurance though. (To be fair, I think I paid $67 a month for it…)

How much more expensive do you imagine it will be now, given how much healthcare costs have risen in the last 10 years? My guess is that was was a good but expensive plan will wind up being totally unaffordable for most people. I mean, if you’re paying $2000 a month but get your 4 endo visits free and insulin for $10 a month, it still may not be worth it to be in a high-risk pool most years, except for the potential for DKA or long-term complications…

@ClaudnDaye Options if you lose your job and insurance coverage:

–State high risk pool, as @Chris mentioned. I also had the California MRMIP plan for a couple of years. It was great!
–COBRA
–Choose a low cost medical plan, many of which will be popping up once Obamacare is history. That will continue your insurance until you find another job.
–If all else fails, Medicaid.

There are options that can keep you from becoming uninsured.

The bottom line is that Obamacare is an abject failure and is not sustainable. It was rammed through without necessary support for a bill of its magnitude. It so deformed our healthcare system that it will take years to straighten out, if ever.

Thankfully, one thing that “Trumpcare” will do is provide a means to develop alternative products to serve anyone who wants to have medical insurance.

1 Like

Hard to say, we paid about $1900 a month for that insurance, but it was fantastic. We currently pay about $1300 a month for the big HMO out here. Then we pay about $200 a month for medications. Seems they have diabetics dialed in, where you pay just enough so you hit the max out of pocket in December so you don’t go on a purchasing binge. There was great peace of mind to know that when you pay your insurance bill, that is the total amount you will have to pay for the month, rather than the nickel and dime approach we currently enjoy.

The bottom line is that Obamacare is an abject failure and is not sustainable. It was rammed through without necessary support for a bill of its magnitude.

you should be outraged then that the Republican senate is planning to pass a bill that none of us have seen next week, which none of the senators except about 13 have seen, and which has been subject to no debate.

I completely disagree by the way about Obamacare. I know tons of people who got insurance for the first time in years. For them, it’s fabulous. Even for me – I don’t use my employer health insurance but it’s gotten noticeably better since I started working there and the emails we receive from HR indicate that this is a direct result of Obamacare requirements. And the degree to which it’s good is also directly related to whether your state chose to enact the legislation and capitalize on it to the full, or whether it’s policy was obstructionism (as is the case in Texas.). I have no doubt the program is working a lot better for people in California than it is in Texas.

The main issue I have seen is that now that more people are seeking care, there arent’ enough doctors to go around. So wait times are longer. But to me, the solution is simple: Open a lot more medical schools. (And get rid of the O-Chem requirement, haha.)

2 Likes

Did your son have diabetes then?

No he did not. We were denied because of (treated) high blood pressure and allergies.

yeah, so my guess is a) with inflation and high level of health needs in the population (the population is now older and sicker, and many people qualified for cheap insurance back then will now need a high-risk health plan), that same fabulous high risk plan, with the same level of funding, would be closer to $4k or even $5k a month when you factor in a child who has baked in medical costs of about $10k a year. You may not love your current insurance, but it seems you’re paying about $1,500 a month for it. Is paying two or even three times as much for a plan that doesn’t feel as stingy really worth it?

And your experience being denied is pretty common. I was denied at 22 from a Texas plan because I had had acne as a teen and took Retin-A.

Actually, the physician shortage is real, and opening more medical schools isn’t going to fix the problem. The problem is that being a physician today basically sucks. I have known at least 10 physicians that have fled practice to work for companies, because they weren’t able to practice medicine in a fulfilling way anymore. It doesn’t matter how many you churn out, it will end the same way.

Bureaucrats are winning, and physicians are losing plain and simple.

2 Likes

opening medical schools will absolutely solve at least part of the problem. They still only admit 20% of their applicants. If they doubled medical school enrollment (and at the bare minimum expanded residency programs to accommodate the new people), you would have twice the doctors in 5 or 6 years. It’s not like medical schools are going begging for applicants.

Obamacare is a failure for several reasons. It is not because some people who were not previously insured got insurance.

It failed because, as @Chris said, it put bureaucrats in charge of medical care and shut out doctors.

It failed because it is fiscally unsustainable. Why doesn’t the government just give everyone a 2500 sq ft house in a good neighborhood? Because the government (us) can’t afford it.

It might be what the “gimme” part of society wants, but somebody’s got to give up an awful lot to pay for it.

1 Like

Honestly what you are carping about is stupid. I worked for a medical device manufacturer during the ACA negotiation and the government picked winners and losers. One of the winners in the ACA was pharma, who gave up a little to get a lot. Losers were med device firms that didn’t feel they had the margins to give up what was being asked and were therefore slapped with a punitive tax on their TOP LINE revenue, so every startup was taxed from day one and was less viable after the ACA went through, and every big company did a layoff to pay for this tax.

What you should be mad about is the government picking winners and losers, not whether the D’s win or the R’s win. We have a problem people, the problem is the center no longer has power. Until such time as people wake up and support the center and ignore both the left and right, we are doomed.

3 Likes

Also, I hate to push back too much on this notion of doctors hating their work…but have they worked in the rest of the economy? i can assure you that many, many other jobs suck so much worse. A handful of doctors may wind up quitting to work for pharma or biotech, but the vast majority are NOT quitting. For every doctor you know (possibly a bit older than me?) who is quitting, I probably know one or two who are just now entering their practices and have gone to medical school in the age of Obamacare. Practicing medicine under Obamacare is what they signed up for. And they’re pretty angry about the potential for care being ripped out from under their patient’s noses.:
https://www.forbes.com/sites/dandiamond/2015/06/02/why-doctors-really-quit/#2b7485047621

Most everyone hates change. But change is needed when the system isn’t sustainable.

Students taking on $200,000+ in debt don’t want change, they want stability that means they can pay off this debt. Does this make them a little myopic, perhaps.

Speaking of changes, physicians and residency programs would need to be changed radically if your program to increase the number of doctors was implementable. If you don’t find and increase the number of specialty residency programs available you will just dump a bunch of general practitioners on the market who won’t earn enough to pay back their debt.

Also, physicians don’t hate their work of caring for patients, they hate doing hours of paperwork to get pre-approval for something that should already be pre-approved. They hate having to go to meetings to explain why one of their patients stayed in the hospital 0.7 days longer than the average patient. They hate being told by a hospital that they need to change the percentage of “unprofitable” procedures even though their patients need these procedures.

1 Like

I don’t like the R’s answer any more than I like the D’s answer. I think the real answer lies in the middle and isn’t being considered. Having been in industries that are directly affected by these legistrations, and working with doctors that are directly affected, I think I have a different view than many.

The current system (ACA) is unsustainable, period. Many insurers are pulling out of markets leaving a huge percentage of people with one choice. That is stupid and unsustainable.

Change is needed. I won’t parse one solution vs another. Change is needed, and the R’s are offering change. That at least offers opportunity.

3 Likes

I didn’t offer that up as a solution to the healthcare crisis. I was responding to Tia’s comment about physicians enjoying their work.

Any solution that increases bureaucracy will lead to more of what I mentioned. Any solution that reduces bureaucracy will have the ability to make physicians better able to deliver care.