Many people have insurance but they chose to not seek healthcare and the reason is due to deductibles. Depending on where you live, your premium could be cost prohibitive even in a lower tier. Lower tier plans also include deductibles under which are virtually all tests and procedures. Sure, the insurance will pick up the tab for the office visit (minus the copay) but the rest of it is on you until the deductible is met. Given healthcare costs, you could easily rack up hundreds of dollars in charges that the insurance company is not going to pay because you haven't reached your thousand(s) dollar deductible. It makes going to the doctor cost prohibitive. Some people would rather ride it out and hope the problem goes away. This is especially the case with people who barely make ends meet. I see them all the time in my practice. They hope and pray the solution is medication alone but quite frankly, there is little a practitioner can diagnose without testing.

Unless this scenario is addressed a single payer system does not solve all of the problems.

If people are reasonably healthy they don't see the net benefit of paying for insurance given the premiums and the fact that lower tier plans have high deductibles under which are virtually all tests and procedures. Yes, you will get a refund but if you are living month to month and do not have savings, you could be looking at paying out of pocket anyway even if you have insurance. My wife and I have insurance through her employer and nearly $400 is taken out each week. I rarely get sick but I ended up getting sick about a year and a half ago. I had to go to the ER and have an ultrasound, xrays and lab work. I ended up with a bill over $1000. Thankfully we had it but the only thing the insurance covered was talking to the doctor for 15 minutes. The rest was on me because it fell under the deductible. This is the calculus at play here with people who would rather take the penalty than get insurance. Healthcare costs are still expensive and the insurance companies continue to raise rates depending upon where you live. Because premiums vary greatly state to state, the cost for even bronze level insurance can be prohibitive. We live in Massachusetts which traditionally has some of the highest rates in the country. Do not get me wrong, I do not despise the ACA in general. Some of the new rules were necessary. No one should be forced to go without insurance. I'm glad lifetime caps have gone. Providing free yearly well care should theoretically drive down costs (of course it requires consumers to take advantage of the benefit) etc. My biggest gripe is the government got in bed with the insurance companies. They aren't in the business of charity and the last thing they are willing to do is take a hit to their bottom line because the government made them insure people they previously denied.

I would only add that, the public option would have been a good tool to help keep insurance providers more 'honest' but joe lieberman played a large part in sinking that(ug). They've played such critical roles in the sinking healthcare reforms in the past, that I can understand the hesitancy to take them on more directly, but still.

At least The 80-85% mandatory threshold that insurers must pay towards benefits vs. profits is sort of useful, but it is a percentage and if the total premiums rise than those profits do as well.

Oh well, I think it was a case of 'doing the best you can, with what you have', where you are in terms of the votes & circumstances at the time. I hope Hilliary Clinton will at least talk about trying to get the public option back in. Sure single payer would be nice, but there's nothing to say it can't help transition into it, if conditions are right. It will likely save money in the long run imo, by keeping premiums down so that insurers can't leach off the guarantee of subsidies from the government

of us working people. I guess she needs their money to get elected. At least she's not lying about a public option like Obama did.

ARRA and PQRS. Two completely useless programs that disrupt practices and absolutely do not amount to better healthcare. I do not know your specialty but why are physicians being forced to select from a list of measures that have absolutely NOTHING to do with the patients they treat? Implementing measures that require patient compliancy? If you are a neurologist, how the hell are you going to get dementia and aged patients to adopt patient portal let alone use the thing? Transition of care? Have you see what other physicians are sending out as chart summaries? I realize the latter is largely to do with individual EMRs but that's the problem. Our government got in bed with the insurance agencies and we also got in bed with the software agencies. Its preposterous.

Are you sure the '15 minutes with the Doctor' was the only thing your insurance covered?

It used to be that the deductible only kicked in if you were admitted but today most insurances require a deductible for all labs and rads. It is how insurance companies are able to maintain their bottom line without sky rocketing premiums. It is only partially helpful though because now that people with preexisting conditions have those covered, the insurance companies are paying out more than they ever did previously. In order for the ACA to drive down insurance costs, healthcare costs in general must be reduced. It isn't going to happen. The cost of healthcare is directly tied to the insurance companies themselves. The way insurance companies maintain their margins is three fold: reducing coverage (deductibles), increasing premiums, reducing allowable charges from network providers. This isn't just a commercial industry problem. Medicare and Medicaid engage in the same tactics. Medicare continually pays less and healthcare providers largely rely on medicare. Healthcare costs are increased across the board because they can make up some of the difference. Some would call this shady but it is the cost of doing business. In order to keep their doors open, they need to engage in this activity. not for profit healthcare providers are the way to go as you are likely to receive better care and at a better cost but they still need to compete. The entire industry is broken.

Consider ARRA - (American Recovery and Reinvestment Act of 2009) which mandated that physicians engage in what is called "meaningful use" which involves the implementation and usage of electronic medical records. The entire premise of this program is that through meaningful use, providers will be able to have more accurate, quicker and easier access to patient medical records along with providing patients more information concerning their healthcare. The theory is that if implemented, patients will be less sick and require less healthcare because mistakes, misses and errors will be driven down. It has been in effect for 5 years now and Medicare has yet to see any change. It is a ridiculous program. I believe physicians should be using EMRs but the program itself is a waste of money. Physicians are offered a payout of 44k over 5-7 years broken up into chunks if they participate. If they fail to participate, they will receive a 1% hit to their reimbursement every year up to a maximum of 5%. They must also implement this program among all of their patients regardless if they are medicare or not. Now CMS (Medicare) is forcing providers to participate in PQRS which is a program that tracks specific quality healthcare initiatives that for the gross majority of specialists do not apply.

This is why when people talk about single payer or public option, I get aggravated. This isn't an ACA or Insurance or Healthcare Costs problem. Its an industry problem.

Health care shouldn't be a 'for profit' Corporation.

I know the lab machines are expensive but after a clinic does 10,000, $400 WBCs on that machine it paid for itself and the Tech to run the test.

You are so cute the best resource would be https://healthcarebluebook.com/page_Default.aspx it gives you the average fair price of medical costs based upon where you live. Just keep in mind that the fees vary widely depending on region, whether you are in a hospital, negotiated rate with individual insurance companies etc etc.

I see no problem with that. However, it is not always easy to make that determination. As I said, costs can vary greatly even within states. If you play around with that link you'll see what I mean. Massachusetts is one of the most expensive states in the country for healthcare and yet the fair price for let's say an MRI can vary by 200 or more depending on where it is performed. In Boston it would easily be well over $1000 yet where I live probably 2 to 3 hundred less. So long as insurance stays at the state level, we will always have cost disparity. A national single payer system would solve some of the problems but if it goes the way of medicare, healthcare costs will still increase.

many countries. cost is about $2.00 a 'box', sells for about $12 as over the counter in other countries.

your link for what is called consumer "fair price" lists Mifeprex for about $250, same price at 3 major pharmacies. RX med here in America so all the medical industry can make a killer income too.

Americans are being price gouged-ripped off by the entire Health care system.

it before it was mandatory, I wonder about your grip on the English language. You do know what mandatory means, right?



A profile of Clinton supporters is developing

You should be ashamed. Yes, insurance is "mandatory." But many poor people are now covered by expanded Medicaid at no cost, and many others can get insurance at affordable rates... Something they couldn't do before.

Yeah, that's awful that more people have access to affordable health care.

Or the post to which you allegedly responded?

The president's desire to serve the insurance and drug companies instead of the people who voted for him caused the insurance bills of people like me to go up by 8000/year, to where I'm forking over 20% of my take home pay to the bloodsuckers who provide nothing but campaign contributions. The president's awful deal with big insurance pretty much precludes us from ever getting them off our backs. Why are you so happy that we have the worst healthcare system in the world?

You mistake bho for a dictator ...

I checked it and don't know when the next enrollment period starts.

I'm in one of those states that doesn't want that dirty money from Obama's hands.

Apparently you can enroll any time if certain events have happened in the past 30 days such as a job change or a death in the family. None of those things have happened to me and I was told on the website that I was ineligible to enroll.

I entered my info (I have insurance) and said I will move, I used my friends address 8 miles away.
https://www.healthcare.gov/screener/sep-result.html
result
It looks like you may qualify for a Special Enrollment Period
This means that you can probably enroll in a 2015 health plan through the Marketplace even though the annual Open Enrollment period is over.
To find out for sure, fill out a Marketplace application or update your existing one.

The open enrollment is about Nov. 1 to Jan. 31.

I don't know your details and wish I could help more. I'm in Texas, earn above the poverty level so was able to use the healthcareDOTgov website to choose a policy. I live in a state that hasn’t expand its Medicaid program. Texas does have a medical program called "gold card", I helped a neighbor with low income apply, he now has access to healthcare through a hospital clinic.

On the healthcareDOTgov. application you 'guesstimate' your years income. You do want to estimate your years income as close as possible because when you do your IRS tax report you will report your gov. subsitity on your IRS form.

Hope this helps you. A positive is November 1 'open enrollment' is only a few months away, can apply now and call their 24 hour number for questions and help.

worked hard for decades for some type of 'first world' health care system for Americans.

Now if we can only cut out those profit grubbing middlemen and make non-profit medicare available to all Americans.

Let us pay our premiums and put the federal subsidies into 'Medicare for all' health care.

but with single payer it'd be more like 100%.

You can't have the house all built up and finished and painted and ready for human occupancy if you haven't put the foundation in first. And as we all know to one extent or other - construction projects tend to take time (and usually, much more time than originally projected or expected).

Working pretty well for them too.

They don't WANT to help you. They don't WANT to help ANYBODY. They're the Party of Cain. "Am I my brother's keeper?" Hate to break it to you, CONS, but YOU BET YOUR SWEET BIPPY YOU ARE!!!! We ALL are our brother's keeper. Jesus even recommended this.