Following the Rules ... Broken System

Published

There is something wrong when those of us "following the rules" and dutifully purchasing healthcare insurance are penalized by mail order pharmacies for preferring using a local pharmacy with a real live pharmacist and local employees... or having to pay a $500.00 deductible if we go to the Emergency Room over an Urgent Care center.... like I know NOT to go to the ER unless it is serious... yes, I realize a lot of America goes for non-acute care... but why are we left with the penalty.

Up Vote Up Vote ×
Specializes in Critical Care.

How is a mail order pharmacy penalizing you for using a local pharmacy? Do you mean your insurer?

Going to the ER costs money, as does using any healthcare services, so you're expected to help pay for it. An ER visit tends to cost more than an urgent care clinic visit, thus the extra cost to you.

Up Vote Up Vote ×

Pharmacy> If you don't use the mail order they will make you pay a higher co-pay. The mail order company wants you to have 90 day Rxs, but they won't let you fill a 90 day Rx at a retail pharmacy. I actually tried the mail order and didn't like the lack of contact with a pharmacist and being sure I could get my refills when needed.

The point about the ER is that I know when NOT to go to ER, I have worked ER. The penalty discourages people from seeking care they may need. When you pay like 1000.00 am month for insurance, you shouldn't be penalized with high deductibles/copays for seeking needed care. The ER copay last year was 100.00. This year it is 500.00 that is a big increase. If you read about what is happening since Obama care, working people are not seeking care due to the post Obama care plans being so expensive and having such high deductibles. My son-in-law needs surgery. His deductible is 10,000.00.... It is a bigger mess than it was. Insurance companies are posting record profits. We need to go to a single payer and get employers out of the insurance business.

Up Vote Up Vote ×
Pharmacy> If you don't use the mail order they will make you pay a higher co-pay. The mail order company wants you to have 90 day Rxs, but they won't let you fill a 90 day Rx at a retail pharmacy. I actually tried the mail order and didn't like the lack of contact with a pharmacist and being sure I could get my refills when needed.

The point about the ER is that I know when NOT to go to ER, I have worked ER. The penalty discourages people from seeking care they may need. When you pay like 1000.00 am month for insurance, you shouldn't be penalized with high deductibles/copays for seeking needed care. The ER copay last year was 100.00. This year it is 500.00 that is a big increase. If you read about what is happening since Obama care, working people are not seeking care due to the post Obama care plans being so expensive and having such high deductibles. My son-in-law needs surgery. His deductible is 10,000.00.... It is a bigger mess than it was. Insurance companies are posting record profits. We need to go to a single payer and get employers out of the insurance business.

Sure, single payer :roflmao:

To pay for single payer, your taxes will have to go up 20%+

Up Vote Up Vote ×
Sure, single payer :roflmao:

To pay for single payer, your taxes will have to go up 20%+

Which for some may equate to a savings based on what they already pay in taxes & for their insurance benefits/copays/deductibles/etc.

Every situation is different, but I agree that we should have to go bankrupt paying for healthcare when we already pay for it. The problem is that these issues were around before Obamacare was around. People just forget that. In fact before Obamacare you could max out your policy, be denied for pre-existing conditions, etc. Granted it is not perfect, but it is easy to forget what it was like just a few years ago.

Up Vote Up Vote ×
Sure, single payer :roflmao:

To pay for single payer, your taxes will have to go up 20%+

Do you have an actual source for the "20%" figure, or is that just your own estimate/opinion?

Up Vote Up Vote ×
Do you have an actual source for the "20%" figure, or is that just your own estimate/opinion?

Just my number, but surely, how much do you think it'll cost? It can't just be a few percentage points... if a lot of people are paying hundreds of dollars a month, upto a thousand a month for family insurance under obamacare, and if you figure they make $4-5k a month, then bam 20-25% of their income to pay for it.

Up Vote Up Vote ×

Also, look at Europe... they pay through the nose....

Up Vote Up Vote ×
Just my number, but surely, how much do you think it'll cost? It can't just be a few percentage points... if a lot of people are paying hundreds of dollars a month, upto a thousand a month for family insurance under obamacare, and if you figure they make $4-5k a month, then bam 20-25% of their income to pay for it.

It's not smart or fair to spout off numbers like they are facts, when they are simply numbers you made up in your head. It's how ignorance is spread.

Up Vote Up Vote ×
Specializes in Critical Care.
Also, look at Europe... they pay through the nose....

We pay about $9,000 per person in the US for healthcare, European countries pay between about $4000 and $5000 per person, so I'm not sure where you're getting your information from.

Up Vote Up Vote ×
Specializes in Critical Care.
Just my number, but surely, how much do you think it'll cost? It can't just be a few percentage points... if a lot of people are paying hundreds of dollars a month, upto a thousand a month for family insurance under obamacare, and if you figure they make $4-5k a month, then bam 20-25% of their income to pay for it.

Actually, we'd pay less with single payer, that's the point. If we funded single payer through taxes, you're correct that we would likely be paying more in taxes, although we'd have more available from what we were paying in premiums that what our taxes would go up. Personally, if it means less money out of my pocket, I don't care if you call the reduced amount I owe "taxes" or "premiums".

Up Vote Up Vote ×
Just my number, but surely, how much do you think it'll cost? It can't just be a few percentage points... if a lot of people are paying hundreds of dollars a month, upto a thousand a month for family insurance under obamacare, and if you figure they make $4-5k a month, then bam 20-25% of their income to pay for it.

But our current system siphons large amounts of that insurance premium money off the top as profits going into shareholders' pockets, which would not be happening in a single-payer, non-profit system. Most of the people who have actually crunched the numbers realistically have found nothing near that amount, and the increase in taxes would be significantly less than what most people are now paying for insurance premiums.

Single Payer System Cost? | Physicians for a National Health Program

"Single payer could be financed with existing sources of taxpayer funding for health care (including subsidies from the ACA) combined with an average 7.2 percent effective payroll tax on employers, a 3 percent income tax on family adjusted gross income, and cigarette ($1.00/pack) and alcohol taxes (5 cents per drink)."

https://www.healthcare-now.org/wp-content/uploads/2008/09/0312friedman.pdf

How will single-payer health care affect taxes?

"A high income Vermont taxpayer currently faces a top state marginal income tax rate of 8.95 percent and an average tax rate of at least 6 percent. If my estimates are correct, or even close, if these taxes are enacted high income Vermonters will be paying about 15 percent of their income to the state and face a marginal tax rate in the high teens. No other state even comes close to those levels."

(Please note that this article is by someone arguing against a state single-payer system, noting that the tax increase on the highest-earning Vermonters from 6 - 9% up to 15% is too onerous.)

Health Care How Much Does Single Payer National Health Care Cost?

"June, 1998, The Economic Policy Institute

In the model presented in this paper, it is assumed that in the first year

after implementing a universal, single-payer plan, total national health

expenditures are unchanged from baseline. If expenditures were higher than

baseline in the first few years, then additional revenues above those described

here would be needed. However, these higher costs would be more than offset by

savings which would accrue within the first decade of the program.

Universal coverage could be financed with a 7 percent payroll tax, a 2

percent income tax, and current federal payments for Medicare, Medicaid, and other state and federal government insurance programs. A 2 percent income tax would offset all other out-of-pocket health spending for individuals. "For the typical, middle income household, taxes would rise by $731 annually. For fully 60% of households, the increase would average less than $1,000. For another 20%, the increase would average about $1,600...costs would be redistributed from the sick to the healthy, from the low and middle-income households to those with higher incomes, and from businesses currently providing health benefits to those that do not."

And keep in mind that those small amounts of additional taxes would be more than offset by most of us no longer paying huge premiums to insurance companies.

Up Vote Up Vote ×
+ Join the Discussion