The American Health Care Act
May 15th 2017, 4:57 pm
#196
Often not so civil...
Joined: Apr 2010
Location: The Boonies, GA
Posts: 9,561
Re: The American Health Care Act
The problem is this - people who end up not seeing the final bill have no incentive to manage their use of healthcare. If you can afford a supplemental, then you will not receive another bill from a Medicare claim.
The problem we see is that co-insurances go unpaid and end up written off as bad debt. How can you garnish someone who is only getting $700 a month in social security? The co-insurance for inpatient rehab is $164.50 per day, as you can tell that adds up very very quickly.
The only people exposed to the risk of that not being paid is the Healthcare provider, and that's a huge risk for any place that serves an aging population.
The problem we see is that co-insurances go unpaid and end up written off as bad debt. How can you garnish someone who is only getting $700 a month in social security? The co-insurance for inpatient rehab is $164.50 per day, as you can tell that adds up very very quickly.
The only people exposed to the risk of that not being paid is the Healthcare provider, and that's a huge risk for any place that serves an aging population.
May 15th 2017, 5:09 pm
#198
Forum Regular
Joined: Apr 2017
Posts: 227
Re: The American Health Care Act
And what happens to people who make too much for Medicaid but not enough to pay for private insurance ?
Or those on Medicaid who cant afford transportation to a doctor or specialist who accepts Medicaid ? I lived for a while in a large county that had zero public transportation. Some doctors accepted Medicaid, most did not. And for specialists often Medicaid recipients had to go outside the county, which for those without transportation quite a challenge.
Or those on Medicaid who cant afford transportation to a doctor or specialist who accepts Medicaid ? I lived for a while in a large county that had zero public transportation. Some doctors accepted Medicaid, most did not. And for specialists often Medicaid recipients had to go outside the county, which for those without transportation quite a challenge.
May 15th 2017, 5:14 pm
#199
Forum Regular
Joined: Apr 2017
Posts: 227
Re: The American Health Care Act
Medicare is available to those 65 and older. You have the premium deducted from your monthly social security benefit check. In addition, you need to have a supplemental insurance to cover the costs that Medicare does not cover. The supplemental insurance comes with additional premiums, co-pays for each doctor's visit (co-pay charge sometimes fluctuates on the type of doctor you are seeing, i.e. a specialist), each hospital stay, etc. Then there is the need for prescription coverage which also charges a premium and usually has a co-pay. So you premise is incorrect. It is not a free healthcare program and it does come with the expenditures.
Medicaid is free and is a horse of a different color.
As for the DMV, when in NY, it was always done via the internet. Never had to go to the DMV office even to register a new car which was handled by the dealership. The only times I was there were for the initial driver's license, registration of a used vehicle and once to return plates before they started accepting them through the mail. MS is an easy office. Wait time for transfer of driver's license and eye test was all of 20 minutes. Registered the car and paid the personal property tax on the same visit.
Medicaid is free and is a horse of a different color.
As for the DMV, when in NY, it was always done via the internet. Never had to go to the DMV office even to register a new car which was handled by the dealership. The only times I was there were for the initial driver's license, registration of a used vehicle and once to return plates before they started accepting them through the mail. MS is an easy office. Wait time for transfer of driver's license and eye test was all of 20 minutes. Registered the car and paid the personal property tax on the same visit.
May 15th 2017, 5:14 pm
#200
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: The American Health Care Act
Plus you pay for Medicare throughout your working life through the Medicare tax. And, to reiterate for NYer, despite all its costs it gets higher ratings than those with private insurance.
May 15th 2017, 5:18 pm
#201
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: The American Health Care Act
The fact if the matter is that it IS imploding. Aetna has pulled out which should have been a key news story last week rather than Trump's ice cream problems. That means there are probably thousands (if not millions) of people who are suddenly without health insurance. The insurance companies got greedy in the beginning refusing to take the long view.
But my point was that if you think single payer will come out of this you are likely to be disappointed. A return to the days where those with most need of access - i.e. those with pre-existing conditions - are effectively excluded is much more likely.
Last edited by Giantaxe; May 15th 2017 at 5:23 pm.
May 15th 2017, 5:24 pm
#203
Lost in BE Cyberspace
Joined: Nov 2007
Location: Bay Area, CA
Posts: 13,111
Re: The American Health Care Act
My local DMV has a reservations system. If you use that system, your service is very good - you show up close to your appointment time and are serviced very quickly. If you don't use the reservation system, you are likely to encounter very long waits / long lines; they are really pushing the reservation system at the expense of walk-ins. I honestly can't find fault in them over the past 10 years.
May 15th 2017, 5:26 pm
#204
Concierge
Joined: Apr 2001
Posts: 46,391
Re: The American Health Care Act
You have to go to the DMV if you want your car inspected. That can't be done via internet. As soon as that car sticker expires, off to the DMV one goes. Also, I thought with Medicare, you only had deductions from SS if you returned to work. I could be wrong - it IS confusing.
That is not true in New York State. Your annual vehicle inspection is done by your mechanic (if you have one) or the dealership or any station that performs the service. It is mandatory and not optional. It is not done by the DMV.
May 15th 2017, 5:30 pm
#205
Forum Regular
Joined: Apr 2017
Posts: 227
Re: The American Health Care Act
Indeed, what insurance company in their right mind is going to commit to being in the ACA when the party in charge of both houses and the presidency have made it very clear they wish to destroy it?
But my point was that if you think single payer will come out of this you are likely to be disappointed. A return to the days where those with most need of access - i.e. those with pre-existing conditions - are effectively excluded is quite likely.
But my point was that if you think single payer will come out of this you are likely to be disappointed. A return to the days where those with most need of access - i.e. those with pre-existing conditions - are effectively excluded is quite likely.
Obamacare or ACA was designed to fail so that we would go to a single-payer system. I suppose it never occurred to anyone who designed the plan that a new administration would come in and short circuit it. They should have thought about it.
May 15th 2017, 5:38 pm
#206
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: The American Health Care Act
"U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare"
U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare - LA Times
Covering everyone in exchange for a mandate to have coverage is about the best it gets in the US if you want near-universal coverage. The ACA certainly has significant flaws - for example, the mandate is essentially a joke - but other than simply ignoring the sickest, what approach would be both better and politically possible?
Last edited by Giantaxe; May 15th 2017 at 5:46 pm.
May 15th 2017, 6:04 pm
#207
Forum Regular
Joined: Apr 2017
Posts: 227
Re: The American Health Care Act
It's more complex than that:
"U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare"
U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare - LA Times
Covering everyone in exchange for a mandate to have coverage is about the best it gets in the US if you want near-universal coverage. The ACA certainly has significant flaws - for example, the mandate is essentially a joke - but other than simply ignoring the sickest, what approach would be both better and politically possible?
"U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare"
U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare - LA Times
Covering everyone in exchange for a mandate to have coverage is about the best it gets in the US if you want near-universal coverage. The ACA certainly has significant flaws - for example, the mandate is essentially a joke - but other than simply ignoring the sickest, what approach would be both better and politically possible?
And some US judge being pissed-off at Aetna doesn't surprise me at all.
They don't have a clue about how businesses are run. Not that I'm a fan of Aetna.
May 15th 2017, 6:13 pm
#208
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: The American Health Care Act
So no ideas on how to get to near universal coverage without jettisoning the sickest?
So you have no issue with Aetna trying to deceive the court in its merger court case?
Last edited by Giantaxe; May 15th 2017 at 6:15 pm.
May 15th 2017, 6:25 pm
#209
Concierge
Joined: Apr 2001
Posts: 46,391
Re: The American Health Care Act
As for management of healthcare, I go for treatment for glaucoma and diabetes on a pre-arranged six month visit for both diseases. Is this what you consider management? Or is it something else?
The problem we see is that co-insurances go unpaid and end up written off as bad debt. How can you garnish someone who is only getting $700 a month in social security? The co-insurance for inpatient rehab is $164.50 per day, as you can tell that adds up very very quickly.
The only people exposed to the risk of that not being paid is the Healthcare provider, and that's a huge risk for any place that serves an aging population.
The only people exposed to the risk of that not being paid is the Healthcare provider, and that's a huge risk for any place that serves an aging population.
May 15th 2017, 6:30 pm
#210
Often not so civil...
Joined: Apr 2010
Location: The Boonies, GA
Posts: 9,561
Re: The American Health Care Act
People who have a co-insurance or premium on a traditional policy have that weighing against them. Typically a high co-pay exists on ER visits exists so as to deter people from going to the ER. My own insurance will not pay anything on an ER visit if it is deemed to be non-emergent.
Medicare has no such restrictions, so there is absolutely no incentive to go to urgent care versus the ER. That's the problem IMO.
Not 'seeing' a bill for Medicare Co-Insurance makes it seem like there isn't one, that it all costs the same.
Medicare has no such restrictions, so there is absolutely no incentive to go to urgent care versus the ER. That's the problem IMO.
Not 'seeing' a bill for Medicare Co-Insurance makes it seem like there isn't one, that it all costs the same.