Talk of insurance mandate growing - page 5

Talk of insurance mandate growing Source:... Read More

  1. by   VICEDRN
    Quote from DrugReptoNurse
    Must of been one hell of slippery rug to have 3 kids by mistake
    It isn't a question of how they get here, its a question of whether or not you predicted the fast growing costs of insurance and care for them or anyone else in your family. It works both ways: my mother didn't anticipate spending thousands a month on my grandmother because when she was young and living in the UK, people got sick and died quickly. Period. There was no "cost" to care. They died at home.

    I think its overly convenient to argue that you wouldn't have them if you couldn't afford to insure them unless of course you have some kind of crystal ball that lets you know how much every single thing would cost.
  2. by   TinkRN8
    There are so many factors other than "greedy insurance companies", that go into the cost of health care. I was hospitalized long-term 2 yrs ago. The cost of my bill? Nearly $100,000, which is what I would have had to pay had I not had insurance. Insurance paid all but my ded & co-pay totalling $1500. Did the insurance company pay $100k? Absolutely not. They paid only $25k, based on contract prices, etc. Why the mark-up and disparity for private payers? Same service and private payer would pay $100k, but insurance pays $25k.

    Plus, I take two prescriptions for asthma. I tried making arrangements ahead of time to take the meds with me so that I would not have to pay hospital prices. Would they let me? NO. So, they charged $120/pill each day plus $200/inhaler treatment. That is a rip-off. I understand that the nurses need to know what meds you are taking, etc, but I tried to make arrangements ahead of time, and even said they could hold onto them to monitor, but it is against hospital policy, so I was charged insane amounts to cover the extra meds.

    I agree with those who say costs needs to be regulated. Why in Canada is my same prescription from the same manufacturer 1/4 the cost I pay here in the US? And no, it has nothing to do with insurance. I did some research and found out a lot of info about how pharma co's lobby to extend patents to keep raking in money long past expiration dates here in US. Ridiculous. I have had to quit buying one of my meds because I simply can't afford it...even with insurance!

    I honestly don't think insurance companies are to blame completely for this mess, there is enough blame to go around and until ALL areas are addressed nothing will change.
  3. by   AZ_LPN_8_26_13
    Quote from stephenfnielsen
    This very well might be the most complicated subject for the USA since slavery. It is so much more than meets the eye. Is health care a right or a privilege? Should the government support (monetarily) things that large factions of the country don't agree with (circumcision, octomom-ism, stem-cell treatment, elective abortion, sex-change, suicide, and on and on!). There will be blood!
    My guess is that any government-run insurance would not pay for any of the above because they would not be considered "essential" medical procedures. You'd still have to pay for these things on your own. And put me down in the camp that believes that access to basic essential health care is a right, the same as a right to a basic public education. It shouldn't come down to how much money you have or don't have.
    Last edit by AZ_LPN_8_26_13 on May 21, '09 : Reason: correct spelling error
  4. by   Multicollinearity
    Originally Posted by DrugReptoNurse
    Last time I checked cell phone bills were running $100 a month. You can get HEALTH INSURANCE for less than that.
    Quote from multicollinearity
    Only if you are a male under 25 years of age who has zero pre-existing conditions. And that rate will go up, quickly. The average health insurance policy for a family is $12,300 per year. (Hint, I'm an insurance agent.)
    In hindsight, I should have said you can't get a policy for less than $100 per month that is a real health insurance policy. Yes, you can get a "limited benefit" plan on the cheap for less than $100 per month that leaves you exposed to hundreds of thousands of dollars in medical bills. You know, one of those policies that won't cover chemotherapy or MRIs or physical therapy or prescription medications or doctors' office visits.

    One of those policies that means you'll end up on medicaid if you have a big health problem (unless you have ~200k in the bank to pay for medical adventures). That's not what I call "real" health insurance. "Limited benefit" health coverage is not a solution, it is an insurance card in your wallet masquerading as "health insurance." It's insurance companies offering cheap and confusing plans that rely on the public medicaid system to pick up catastrophic bills.

    I keep "harping" on this because these "limited benefit" policies are exploding in the individual health insurance marketplace, and most people have no idea just how bad they are. These are the plans being advertised on certain AM radio shows and being offered by the largest players in the individual health insurance market. Plans made for bankruptcy court.

    tnstaafl.
  5. by   DrugReptoNurse
    "limited benefit" plan on the cheap for less than $100 per month that leaves you exposed to hundreds of thousands of dollars in medical bills. You know, one of those policies that won't cover chemotherapy or MRIs or physical therapy or prescription medications or doctors' office visits. One of those policies that means you'll end up on medicaid if you have a big health problem (unless you have ~200k in the bank to pay for medical adventures).

    My policy is a limited benefits plan. I just read the fine print a few hours ago for my own reference.

    It covers everything you mentioned except doctors office visits.

    Yep, I get MRIs, Chemo, physical therapy and PRESCRIPTION medications.

    Do some more research as your statements are flawed. After my $2500 deductible BCBS covers at 80% whatever I am charged and I pay $47 a month for me and $47 per month for my son. My total annual out of pocket will not exceed $5000 a year. Your scare tactics of going on Medicaid and filing for bankruptcy are without merit.

    I am happy
  6. by   Multicollinearity
    Quote from DrugReptoNurse
    "limited benefit" plan on the cheap for less than $100 per month that leaves you exposed to hundreds of thousands of dollars in medical bills. You know, one of those policies that won't cover chemotherapy or MRIs or physical therapy or prescription medications or doctors' office visits. One of those policies that means you'll end up on medicaid if you have a big health problem (unless you have ~200k in the bank to pay for medical adventures).

    My policy is a limited benefits plan. I just read the fine print a few hours ago for my own reference.

    It covers everything you mentioned except doctors office visits.

    Yep, I get MRIs, Chemo, physical therapy and PRESCRIPTION medications.

    Do some more research as your statements are flawed. After my $2500 deductible BCBS covers at 80% whatever I am charged and I pay $47 a month for me and $47 per month for my son. My total annual out of pocket will not exceed $5000 a year. Your scare tactics of going on Medicaid and filing for bankruptcy are without merit.

    I am happy
    You are in happy denial, and I don't believe you understand your policy. Most people don't. Your above statement mimics some common errors regarding what people think or assume is covered after their deductible.

    According to your profile, you have an MBA. Wise up. Super cheap insurance policies are "cheap" for a reason.

    tnstaafl
    Last edit by Multicollinearity on May 21, '09
  7. by   blue note
    Quote from DrugReptoNurse
    You might want to take an economics and finance class before you start talking up Medicare. Just in case you haven't heard....Medicare and Social Security are both facing insolvency within 10 years if not sooner. I don't plan on either being here when I retire in 25 years and neither should you.
    You might want to take a read at what Princeton economics professor Uwe Reinhardt says on this issue:

    Part 1: Why Does U.S. Health Care Cost So Much? (Part IV: A Primer on Medicare)

    Part 2: U.S. Health Care Costs, Part V: Can Americans Afford Medicare?

    Part 3: U.S. Health Care Costs Part VI: At What Price Physician Autonomy?

    Medicare is horribly ineffecient and full of fraud. I even believe shows like the liberal 60 minutes have showcased the amount of fraud in the system.
    As opposed to fraud like health insurance companies illegally dropping customers and having to pay big penalties and reimbursements? Here's another one about Blue Shield and Blue Cross having to pay $13 million in fines.

    Private insurers are in the business to make sure fraud doesn't happen.
    Quite the opposite in fact.

    They serve a purpose as middlemen. They do a good job in my opinion of eliminating waste.
    Wrong. They add to the cost of health care because of indefensible administrative costs.

    I prefer to stick with professionals who understand nursing/medicine even if some of you prefer to call your brothers and sisters in arms "cubicle monkeys"
    This insurance company paid its senior cubicle monkey $20,000 in bonuses for "meeting or exceeding annual targets for revoking policies," about 1,600 policies between 2000 and 2006.

    You are extremely naive at best if you think that insurance companies care about nursing or medicine instead of maximizing their profits at the expense of customers.
  8. by   AZ_LPN_8_26_13
    Quote from multicollinearity
    You are in happy denial, and I don't believe you understand your policy. Most people don't.

    According to your profile, you have an MBA. Wise up. Super cheap insurance policies are "cheap" for a reason.

    tnstaafl

    My wife and I now both work for a healthcare provider that is self-insured and has excellent and affordable healthcare. But we both know what it's like not to have health insurance. A few years back, when we were without health insurance, before we were working for who we are now, we both sat down with a reputable insurance agent who gave us some quotes from a few different individual health insurance plans. The figures we were quoted ran in about the $500 to $600 a month range. And we are both in relatively good health, with no chronic diseases or ongoing medical conditions. One thing working against us was our age - we were both in our early 50's. No kids at home. At that time we could not afford to pay $500 to $600 a month solely for insurance (probably not today either) so we declined on getting a policy, and just basically crossed our fingers and hoped we wouldn't get sick. I'd be leery and skeptical myself of any outfit that tells you that you can have real health insurance for less than $100 a month.
  9. by   Multicollinearity
    Quote from DrugReptoNurse

    My policy is a limited benefits plan. I just read the fine print a few hours ago for my own reference.

    It covers everything you mentioned except doctors office visits.

    Yep, I get MRIs, Chemo, physical therapy and PRESCRIPTION medications.

    Do some more research as your statements are flawed. After my $2500 deductible BCBS covers at 80% whatever I am charged and I pay $47 a month for me and $47 per month for my son. My total annual out of pocket will not exceed $5000 a year. Your scare tactics of going on Medicaid and filing for bankruptcy are without merit.

    I am happy
    Read that "Limited benefit" policy again, especially regarding the passages I highlighted with bold emphasis above.

    How can you make sure you don't end up with junk health insurance?
    Consumer Reports says never buy a policy labeled "limited benefit" or "not major medical insurance."

    "The policies are like Swiss cheese. And the way they're written, it's really hard to spot the gaps," said Nancy Metcalf, with Consumer Reports. "Even the insurance expert we hired to help us with this project had a hard time deciphering some of them."

    Consumer Report said the buzz word on many junk policies is "affordable."
    "Many big-name insurance companies are offering these. They look like a good deal because the premiums are low – but they're low for a reason," Metcalf said. "They are so riddled with loopholes, limits and exclusions that they will not come close to covering your expenses if you ever fall seriously ill."


    http://www.wral.com/news/local/story/5190880/


    ...


    Many people who believe they have adequate health insurance actually have coverage so riddled with loopholes, limits, exclusions, and gotchas that it won’t come close to covering their expenses if they fall seriously ill, a Consumer Reports investigation has found.

    http://www.consumerreports.org/cro/m...view/index.htm
    Last edit by Multicollinearity on May 21, '09
  10. by   Agrippa
    Quote from DrugReptoNurse
    What you may or may not realize is that those people you are calling "cubicle monkeys" are very often....REGISTERED NURSES!!!

    I know, i've worked with them. I think the name calling needs to cease at this point.

    Who's name calling? You're really take offense of me calling a hypothetical underwriter a cubicle monkey? C'mon now.

    I know that many of them are nurses but am not quite sure what that has to do with anything. My point was that the person who is making the decision of whether you get a treatment or not is a third person who in all likelyhood works in a cubicle. This person makes the decision by entering into his/her computer the variables that pertain to your situation. The decision is made based upon how much the procedure costs - whether it will affect their profitability. They will take into consideration the possibility of you taking this to litigation or just eating it. If you do take it to litigation, they will take into consideration the state's particular civil laws for one to determine their chances of winning.

    If the chances of you taking legal action and actually winning is great, they may pay for your procedure. If the price of your procedure costs well over a million dollars and they feel that they can weasel out of the policy, they'll risk you suing - it would be cheaper to litigate.

    The key point here is that the problem with private healthcare is that it is systemically flawed. A private company's primary concern is that of it's principal shareholders - and rightfully so. Companies excel by maximizing profits and this works great for things like electronics, medicines, cars, computers, and other material things. But when this is applied to healthcare, there is a clear conflict of interest. The shareholders vs. the patient. In this model, paying out for procedures is inversely related to shareholder's interest.

    I don't blame the companies, they're doing their job to make as much money as they can. They're playing the game as it has been set up. However, as consumers, we now see that the game is rigged - the rules favor the companies. We need to change the game.
    Last edit by Agrippa on May 21, '09
  11. by   DrugReptoNurse
    I do take offense to "cubicle monkey"

    As an African America the word monkey obviously is offensive to me when used in your context.

    I would say about 1/4 of the insurance auditors I worked with at PacifiCare were African Americans. Yes, it does offend me as I am sure it would offend my prior coworkers.

    I believe when you spiral down into name calling #1 It shows a lack of character and #2 It weakens your arguement.
  12. by   Agrippa
    I'm sorry, but this is ridiculous. I think we both know that in no way does the use of cubicle monkey have any reference to race in any way in popular culture. I didn't even know you were African American so I have no idea how you made the connection of my use of "cubicle monkey" to AA. I have no way to know of everything you may take offense to, especially about something like "cubicle monkey" which there was no way for me to have known that you took offense to it in that way.

    I'm sorry that you take offense, but don't you dare try to accuse or even imply that I used that term in a racial way. I even explained exactly what I meant by it.

    If you like, I'll use the term "cubicle automaton" just so that you're not offended.

    And I will also apologize to this hypothetical person - this said cubicle automaton, that you believe I've called a name.

    Be well.
  13. by   Multicollinearity
    Here is a California Nurse's Association article about insurance mandates and "limited benefit" health insurance policies.


    http://www.calnurse.org/media-center...temID=29182756
    Just a few days before gallbladder surgery, she found out from a hospital that the little-known kind of policy she bought 2 years ago would cover only a small portion of the bills. She will pay thousands of dollars out of her own pocket because the policy caps payouts for various services at very low amounts.


    "I cried for two days because I didn't know what I was going to do," said White, an instrumentation technologist in Lake Jackson, Texas, who had to have her gallbladder removed before it ruptured. "I was just devastated. I was angry."
    White, 34, has a "limited benefit plan," which employers increasingly offer hourly, part-time and temporary workers, and insurers such as Aetna and CIGNA see as a growing opportunity.


    In a nation of 46.6 million uninsured, including 407,000 in Connecticut, the plans have spurred impassioned debate about the question "Is something better than nothing?" and whether they're a good step toward universal health care.

    The plans' premiums are thousands of dollars cheaper than regular health insurance, sometimes costing less than $1,000 a year for an individual...

    Not all buyers may understand that limited benefit plans, unlike high-deductible health insurance or home and auto coverage, aren't meant to cover life's catastrophes. Insurers insist their marketing doesn't try to portray the plans as comprehensive coverage for serious illness.

    It seems many people don't understand what limited benefit plans are, and how they aren't the answer to those lacking coverage.

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