in the majority of those cases, both spouses were covered by health insurance.

I don't know if they have had enough time to compile statistics about medical cost bankruptcies after Obamacare.

BTW, when you file for personal bankruptcy, hospitals, labs, docs, etc. are not the only creditors who are SOL. So, I imagine big business should have an interest in getting this stuff sortred out. Credit card issuers, to name one sector, should be interested.

--never get expensively sick.

If you are one of the 5% of every demographic that accounts for 50% of the costs of that demographic, you just become part of a new demographic when you move from, say, 29 to 30.

for me. My ACA policy is really working out well. There are co pays for visits I'd have had to pay a full charge for before I had it. My deductible is way lower. And the preventive stuff is covered.

--a plan with deductibles that requires less money--which they still don't have.

and the huge health insurance industry is still rolling along, and the sweet scams are still working, and that's important.
Sheesh, let's keep our priorities straight.

Almost everybody gets expensively medical at some point...if you are lucky. After a relatively incident-free youth and adulthood, I find myself increasingly in need of medical care. If I were back in the states, my current medical team and their intentions would bankrupt me. As it stands, its only an expensive hobby. Its not really insurance if you can't afford to use it.

Exactly. Our deductible in the states was $2500 a year per person and the last year we lived in the states (2014), I met that deductible and then some. Mostly because I went out-of-network to treat my thyroid disease as I couldn't find an MD in my network that knew how to treat me. I found a Naturopathic MD that did and thankfully, I'm in remission now thanks to her assistance in educating me, along with some good books on the subject.

Just like our home owners insurance. If you make a claim, they raise your rates or cancel you all together. Insurance in the states is an outright scam and it needs a total overhaul in my opinion.

Hope you stay well!

I thought that was forbidden under the ACA -- they have to accept everyone at the same rate (based on age and zip code, but not on health history).

Not saying they don't try to discourage unhealthy people -- by what drugs they have on their formulary, for example, comes to mind.

And by having too-narrow networks as you describe.

Or ending up in an in-network hospital only to later find out that your surgeon or anesthesiologist or whatever is out of network. Grrr.

I'm glad to hear that you thyroid condition is in remission

but I meant cancelling your home owners insurance, not your health insurance. That actually happened to us and it was not a good situation. It was awful.

that might not have existed before. My doctor is monitoring my blood sugar and cholesterol like crazy. I couldn't afford that before the ACA. She is on a crusade to prevent heart attacks, strokes and diabetes (which would be more expensive than her continual blood tests and assigning me to a nutritionist).

No individual deductible. Then they call asking me to stop using the local pharmacy and use theirs to save money. I told them I use the more expensive one because it really doesn't matter since we will always hit it.

I save my healthcare issues for after the deductible is met and our HSA builds up again.

Of course, the sum total of expenditures for that group are far higher than for those 20-30.

I sometimes wonder how much Single Payer advocates have actually dealt with Medicare.

while Traditional Medicare still has deductibles, I have bought a supplemental policy (the most expensive one available in my region), so that I no longer have deductibles (YAY!). To top it off, my monthly premiums are now $350 LESS (even including the supplement) than they would have been if I had stayed on the insurance that I was on last year.

Finally, I can afford to take care of some issues that I've had for a long time and which were too expensive but still less than my deductible.

Why can't everyone have this? Adding younger, healthier people would actually shore up Medicare's finances. The Republicanite proposal to raise the age of eligibility would make its finances worse, because the average 70-year-old has more health problems than the average 60-year-old. Add everyone over 50, and you'd be including a lot of people who are hardly ever sick.

Because it would increase government spending by about $1.2 trillion (probably more when we address current underutilization). It would do that while lowering private expenditures by about $1.5 trillion, and conservatives need to stop pretending that's not the case, but increasing government spending by that amount is going to be a huge road to hoe.

The fine is cheap and will be for another 3 years and then it might be adventageous for the younger groups to sign up for ACA.

before he wasn't

Obama: Public Option Part of Health Plan

Reid too, until HE wasn't

Reid: Public Option in Senate Health Bill



But if you didn't like Obama's Heritage Foundation Health plan- you were a racist. That's the only reason one would have been against it. I read that here.

Bitter Pill: Why Medical Bills Are Killing Us
Time.com Steven Brill April 4, 2013
http://time.com/198/bitter-pill-why-medical-bills-are-killing-us/



A money funnel has been created under a D admin that pipes tax money directly into the bottom lines of insurance companies.

Seen the stock charts lately? If a Republican had done that there would have been calls for public boycotts. Like Keith called for, before he was fired.



Make a law that requires the citizens to purchase corporate insurance without a public option? Only a D could have done that. Like Nixon sending Kissinger to China. Make sure to pay your premium on time- or you could lose *everything*. Like before.

Didn't insurance and pharmaceutical companies draft this legislation in secret in the WH with Obama in the room?

The ACA Legislation was largely drafter via the Office of Max Baucus the Chair of Senate Finance. The actual background authors are thought to have been leading lobbyists from the Health Insurance Industry with support from members of the Healthcare Lobby.

Why were they not equally indignant when Obama met in secret with insurance industry types and refused to see single payer advocates?

When I heard that, I knew that we had been had. The purpose of the ACA was to provide a few cosmetic touches to a plan that was meant to provide a federally-subsidized captive market for the insurance industry.

Once the Republicans made it clear that they wouldn't vote for taking Romneycare nationwide, Obama should have said, "OK, guys, you're not going to play, so we're going full-out for single payer. We're going to lower the age of eligibility for Medicare by five years every year till the entire nation has that option. You can be the one to go back and tell those impoverished 60-year-olds in your district that you voted against their having affordable insurance."

become law. The Wall Streeters now have our healthcare, forever, thanks to Obama. They want Education and Social Security as well, and this will not happen if a repuke is president. But with Mrs. Clinton in office, it will happen, and anyone who complains will be called an MRA.

And yes, we can afford it.

profit from the massive military-corporate collusion?!

Health should be a human right. The only reason we are even having this conversation is because we have allowed the premise to slip into privatisation. Capital has overwhelmed democracy. Neoliberal philosophy frames the debate.

I have really crappy state insurance through the state university I work for. The university has tried desperately to get private insurance, but the state mandates it.

I work for a 300 person non profit. My deductibles (senior salaried) are about 1/7 of my take home. For new salaried people, it's 1/4. For hourly, 1/3. And Mrs Clinton thinks heritage care is just fine. Time for something new - really new.

You never know how much a doctor's visit is going to cost, ever. Your insurance may say "Office Visit: $20" so you know it will be AT LEAST $20. I pay at least $1250/month for health care related expenses - about $600 for insurance, and the rest for my costs associated with care. Most of the extra is from previous years care, on payment plans.

My wife has had some health issues, I have 4 kids, but I'm lucky as I only do a yearly physical.

My mortgage is only $550/month.

If we were on single payer, and say I was paying $200 more in taxes because of it, I'd still be $1000/month ahead.

Single payer please!

we will never meet the deductible unless we have something truly horrible happen.

war and healthcare are a racket.

See post #32 for my story.

One of my colleagues' (Pete's) son lives with him. The child's mom lives halfway across the country. The son needs some routine surgery (probably only $75,000 unless he needs an aspirin), but because Pete's insurance is so lousy, they're going to send the patient to the other state, where his mom's insurance is better.

If the stakes weren't so high, our system would be hysterically funny.

I have an Advantage plan (with Humana). I am very healthy, although I've been going to the doctor a whole lot more than I think I should be going. This is the result of failing a physical for a life insurance because of high blood pressure, and although the bp is more or less under control, I'm still seeing the doctor a lot more than I think I should.

End rant.

More to the point, I have zero copay for those doctor visits. For the three meds I'm taking, I get them via an internet pharmacy, and have a zero copay for a 90 day supply. I'm sure that I might instead have a prescription that costs a whole lot more, and I really do count myself as lucky.

I have a brother with assorted medical issues, including having had a kidney transplant several years ago and all that goes with that. He, understandably, hits the donut hole, and recently we (his siblings) all sent him checks to cover that. He had to retire on disability at age 50, has a small pension and Social Security. Which just cover his normal monthly expenses. Not much money at all.

EVERYONE should have as low medical costs and copays as I do. Ideally, everyone would be as healthy as I am, but since that's not possible, everyone should (I know I'm repeating myself) should have as low medical costs and copays as I do. Period. End of discussion. Individual health issues totally notwithstanding. Zero copay for a doctor visit. Zero copay for medications. I don't see any problem here. Do you?

We pay $987 a month for a bronze plan covering a family of three in WA state. It was purchased outside the exchange since we don't qualify for any subsidies, and providers accepting ACA coverage are a significant drive away. It has a $10,000 deductible!!!!!!

For essentially the same coverage pre obamacare, we were paying ~$500 a month with a $2,500 deductible. Don't tell me "ya but ACA covers more" I know it does, but those extra features are for benefits that are of no use to me.

Makes no sense, and IHMO, the system is still broken. Seriously thinking of going without coverage and banking the premiums.

Too early in the morning to be pissed off!!!!

my GF's daughter just signed up for ACA and she waffled between either a high payment with a lower deductable per month for either the silver or the gold or a higher deductible for a lower payment per month for the bronze.

devil and the deep blue sea.

we as a nation desperately need single payer

It's been a while since I looked at it, but $1,250 a month comes to mind.

the concept of levels of coverage does nothing but further divide the have even mores from the have even less.

it's like a form of casts system based on health and wealth.

It set us back at least 25 years by making the insurance companies part of the government. It will be impossible to get them out.

never looked at it that way.

what could have been.

I don't get why people think that makes them go away

Non-starter. Without dedicated revenues it's held hostage by Congress every two years.

It also has the kind of hand-waving that infuriates me about this: "oh, we'll just replace current private insurance payments with a tax" it's not that ****ing simple. You are going to pass a tax based on current insurance payments? Or are you just going to estimate what insurance payments "should" be? Or are you going to pass a payroll levy and wave your hands about how it's replacing insurance premiums? In any of those cases there will be winners and losers and the losers are going to be furious.

Canada, I think, was right at least about this: this is more sanely done at the state/province level. If it's Federal, the yahoos in Alabama and Wyoming get way more say on my health insurance than I think I can stand.

The only losers are going to be insurance companies and pharma profit gougers.

Yes, it does at least have a separate fund, but that fund is fed by four different sources, only one of which is dedicated to it. It also shakes out to about a 10% payroll levy if I'm reading that right. Including on people who currently don't have insurance, or don't pay for it themselves (their employer does), or can't afford it. And it includes a 10% self-employment tax on top of the current rate. The Chamber of Commerce will have a field day with that, and the electoral map will look like 1984.

The question is as always getting there.

1. The health insurance industry employs about 750K people (it's roughly a quarter of all insurance employment). While they won't all lose their jobs, most of them will, and we need to find something for them to do.

1a. Simultaneously, Medicare Administration staffing will need to expand by (this is my rough guess) about 150%, along with a similar increase in contracting. This seems like an easy solution to 1, and in a perfect world it is, but the Government is so unbelievably slow at ramping up hiring that it would probably end up looking like healthcare.gov but ten times as big.

2. 10% only counts the cost of the treatments currently being delivered to people (this also bothers me about the bill's analysis). Usage will go up. That is the entire point of doing this in the first place. If the 12% of uninsured Americans use health care services at the same rate as insured Americans, it takes us back up to about 15%. But the big question is the currently underinsured: we don't know what their usage rate will be, and if it approaches the rate of people with better insurance, it's going to wind up costing a lot more than our system does now. We simply don't know enough about the rate of underutilization by underinsured people, which is why I think it's dishonest to say we know this will save money. It's not very difficult at all to imagine a scenario where it costs more, if you accept the premise that there is a large amount of underutilization currently.

3. Even if it's the best case and we cut the 17% of our GDP to 12% (IIRC it's that and not 10%, btw), that still represents an increase in government spending equal to 4% of GDP. That is a 20% across the board wage levy, or a 40% across the board corporate tax, or a 10% VAT. There's no getting around how huge of an increase in Federal spending (and so Federal power) that is -- and we need to remember that currently we're giving those reins to John Boehner. But beyond the policy skepticism (I'd much prefer the states do this because of the Boehner issue), the political problem here is a killer. We are advocating a tax (or deficit) increase equal to 4% of the GDP to a population that is less trusting of government than at any point in living memory. It would be a disaster to run on this nationally.

3a. Yes, I know that the tax increase is -- if things go well -- balanced by lower private insurance spending. But lots of people don't see their private insurance spending now (maybe their employer contributes most or all of their premiums) whereas they will see a payroll levy every two weeks. Furthermore, to understand the resistance to this, imagine that your sketchy uncle can get DVDs cheaper than you can at Best Buy. Does that mean you want to hand him your entire DVD budget and trust he'll do it?

4. Even here on the left we have people who are enraged that the government subpoenaed records of who called whom when one of the participants was a foreigner. Not recording what they said, mind you, just keeping the dots in case they want to connect them later. These are business records belonging to the phone company, but people still felt violated and outraged. And now we're talking about the Federal Government maintaining records of all medical procedures whatsoever? That's going to go over like a lead balloon. And I guarantee you a Republican President would abuse it.

If you are going to use the employment argument, then we must also maintain and increase the prison industrial complex. After all, it employs lots of people.

I see no problem with government maintenance of health care records that does not already exist with private medical records--which have already been hacked. We could get Taiwan to show us how to do it--your entire medical history is in your medical ID card there. Same with France--and their system was created by a US company.

Single payer will never be implemented on a national level. What will happen is what happened in Canada. One province gets it, the doctors see their income go up by 2/3, and suddenly all the provinces want it. At that point there will have to be national standards.

Increased utiilization saves lives--that is the whole fucking point of making health care a public good.

https://www.hillaryclinton.com/p/briefing/factsheets/2015/09/23/clinton-plan-to-lower-out-of-pocket-health-care-costs/

The "let's make Obamacare more expensive" argument is not necessarily good politics. The problem does need to be addressed.

Cost sharing shifted to employees yes..... but not wages.

When the Affordable Care Act was enacted, we knew there were going to be problems by the radical republicans who would do anything they could to sabotage the act. What we should now do is complete the migration to single payer, as we have the mandate to do so and the President can just do it through executive order.

He worked for Baucus, then for Obama, now for Cameron and the Tories.

https://en.m.wikipedia.org/wiki/Jim_Messina_(political_staffer)

It was a relatively minor outpatient laser surgery. $30,000 worth of minor surgery. Anyway, I canceled the surgery, thinking maybe that I could get better without the surgery. The specialist told me I would definitely not get better without the surgery.

There's no way can you get better without the surgery, she said.

The day after I was supposed to have had the surgery, I received a letter from my health insurance company informing me that they were not going to pay for the surgery, because the doctor had not tried a certain treatment first. However, the doctor had tried that treatment.

Anyway, I'm completely cured now, without surgery, or any further treatment from the medical establishment. I'm still paying off the medical bills that I accrued from the specialist who misdiagnosed my condition.

The entire healthcare system in the US is FUBAR because of our for profit private healthcare insurance companies. We need universal single payer right now.

I'm voting for Bernie Sanders, the candidate who will do everything in his power to get us single payer. I urge everyone to vote for Bernie.

The life you save may be your own, or your child's.