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Curious on US health insurance

Curious on US health insurance

Old Oct 9th 2021, 5:49 pm
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Default Re: Curious on US health insurance

Originally Posted by Rete View Post
Here is a comparison of the NHS and Kaiser Healthcare in California

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC64512/
"In many ways Kaiser Permanente is like the NHS, providing a similar range of services for a population equivalent to that of a small country."

This is likely why I like Kaiser, which I've had both in San Diego and now PNW. It feels like the NHS in that I may have limited 'choice' but they are efficient and I love the lack of paperwork. Essentially if I walk into one of their buildings I pay $20 regardless of what happens.


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Old Oct 9th 2021, 6:12 pm
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Default Re: Curious on US health insurance

Originally Posted by OldJuddian View Post
"In many ways Kaiser Permanente is like the NHS, providing a similar range of services for a population equivalent to that of a small country."

This is likely why I like Kaiser, which I've had both in San Diego and now PNW. It feels like the NHS in that I may have limited 'choice' but they are efficient and I love the lack of paperwork. Essentially if I walk into one of their buildings I pay $20 regardless of what happens.
HMO’s are an excellent system that emphasizes health versus procedures. They have an incentive to keep people healthy and the set up is better suited to achieve that than regular health insurance. The fact that the US spends about twice what other first world countries spend on healthcare with poorer results seems lost on our politicians.
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Old Oct 9th 2021, 6:51 pm
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Default Re: Curious on US health insurance

Originally Posted by OldJuddian View Post
"In many ways Kaiser Permanente is like the NHS, providing a similar range of services for a population equivalent to that of a small country."

This is likely why I like Kaiser, which I've had both in San Diego and now PNW. It feels like the NHS in that I may have limited 'choice' but they are efficient and I love the lack of paperwork. Essentially if I walk into one of their buildings I pay $20 regardless of what happens.
That’s what I liked about Harvard Community Health Plan when I lived in Boston, many decades ago. Unfortunately only available in big cities and conurbations.
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Old Oct 9th 2021, 8:21 pm
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Default Re: Curious on US health insurance

Originally Posted by ddsrph View Post
HMO’s are an excellent system that emphasizes health versus procedures. They have an incentive to keep people healthy and the set up is better suited to achieve that than regular health insurance. The fact that the US spends about twice what other first world countries spend on healthcare with poorer results seems lost on our politicians.
I would caution though on spending when comparing countries, but there is doubt the US spends more, just when comparing a country like Canada, sure we spend less per person, but we cover less things, a good HMO plan will cover a lot more healthcare needs than the healthcare system will in Canada, so it's easy to spend less when you cover less at the same time, so don't use Canada as en example because while we spend less, we cover less.


Originally Posted by OldJuddian View Post
"In many ways Kaiser Permanente is like the NHS, providing a similar range of services for a population equivalent to that of a small country."

This is likely why I like Kaiser, which I've had both in San Diego and now PNW. It feels like the NHS in that I may have limited 'choice' but they are efficient and I love the lack of paperwork. Essentially if I walk into one of their buildings I pay $20 regardless of what happens.
I had Kaiser through my parents as a kid, and for a time as an adult, and I really like Kaiser myself. Having everything mostly in house is also nice, and major focus on preventive, plus Kaiser included so much, my plan covered all my healthcare needs, mental health, counselling, prescriptions, vision, dental, really wasn't anything that wasn't covered, sure I had to pay $5 to $50 co-pays depending on the service, and premium per check, but all were reasonable with my plan, and didn't cause financial hardship.

I would gladly in Canada pay small monthly premiums and co-payments to have a system more like Kaiser, because Kaiser is superior to any provinces healthcare anywhere I lived in Canada.

Plus being salaried doctors, they are not paid per patient which meant less rushed doctor visits, and less of the assembly line feel much of Canada has with 10 minute appointments with a doctor half out the door, but pay doctors per patient, and they need to maxmize patients per hour.

I have no complaints about Kaiser, and really if all healthcare in the US were regional versions of Kaiser, people would probably be happier over all.

Also while US is often thought of as having nothing but for profit corporations, there are a quite a lot of non-profit health organizations offering insurance, hospitalcare, healthcare, Sharp and Scripps in San Diego are 2 largest in that region and both are not for profit healthcare organizations.


But when I had Aetna insurance they were horrendous, I would never want that style of US healthcare, but Kaiser, I really never had an issue with Kaiser, and being able to self refer to many specialists was nice, and saved a lot of time.

If Canada built a system based on Kaiser even if there were small premiums and co-pays, I would be happy, I would rather pay small amounts and have access to the care I need than to have some healthcare covered, but a slew of things not covered and have no access at all.
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Old Oct 9th 2021, 9:46 pm
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Default Re: Curious on US health insurance

A long time friend who lives in a rural area of Illinois on the Wisconsin border has a long distance from a hospital. To compensate for that, for $65 annually, they are enrolled in AirVac which will take them to a major hospital if the need arises. She had to use it three times in the past and the last time was in September when she caught Covid and her blood pressured dropped and her oxygen count was at 65. There is no deductible and other than the premium no charges incurred.

Last edited by Rete; Oct 9th 2021 at 9:48 pm.
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Old Oct 9th 2021, 10:24 pm
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Default Re: Curious on US health insurance

Originally Posted by Rete View Post
A long time friend who lives in a rural area of Illinois on the Wisconsin border has a long distance from a hospital. To compensate for that, for $65 annually, they are enrolled in AirVac which will take them to a major hospital if the need arises. She had to use it three times in the past and the last time was in September when she caught Covid and her blood pressured dropped and her oxygen count was at 65. There is no deductible and other than the premium no charges incurred.
That isn't a bad deal. It's $80 CAD for BC residents air or ground, but its per use not an annual plan, pay if you use service, but if your not a BC resident which included other Canadian's who live in another province as well as foreign visitors its gets pricey $848 ground, $4,394 per hour for chopper, and $11 per statute mile for fixed wing.

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Old Oct 9th 2021, 10:24 pm
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Default Re: Curious on US health insurance

Treatment aside, we have found Kaiser the extreme opposite of the NHS. Dealing with their billing has been the most stressful experience that we have had in the US, far worse than with any other healthcare provider that we have had. So we switched to another provider.

However, their treatment was good.
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Old Oct 11th 2021, 11:32 am
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Default Re: Curious on US health insurance

Originally Posted by Jsmth321 View Post
I would caution though on spending when comparing countries, but there is doubt the US spends more, just when comparing a country like Canada, sure we spend less per person, but we cover less things, a good HMO plan will cover a lot more healthcare needs than the healthcare system will in Canada, so it's easy to spend less when you cover less at the same time, so don't use Canada as en example because while we spend less, we cover less.
Not only does the US spend more it also has some of the worst outcomes.
https://www.commonwealthfund.org/pub...al-perspective
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Old Oct 11th 2021, 7:22 pm
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Default Re: Curious on US health insurance

Originally Posted by robin1234 View Post
And, although people are free to switch from Medicare Advantage back to Original Medicare, I believe they may be subject at that point to higher premiums on the Medicare Supplement plans that they may then need.
They are subject to medical underwriting, which may lead to either higher premiums or being deemed uninsurable. A lot of people don't seem to be aware of this "gotcha". And this underwriting also applies if you try to change your supplemental plan, with a few exceptions such as relocating to an area the plan doesn't cover or the plan ceasing to exist. So decisions you take when you originally sign up for Medicare can actually affect you decades down the road, if you live that long.
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Old Oct 11th 2021, 7:53 pm
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Default Re: Curious on US health insurance

Originally Posted by Giantaxe View Post
They are subject to medical underwriting, which may lead to either higher premiums or being deemed uninsurable. A lot of people don't seem to be aware of this "gotcha". And this underwriting also applies if you try to change your supplemental plan, with a few exceptions such as relocating to an area the plan doesn't cover or the plan ceasing to exist. So decisions you take when you originally sign up for Medicare can actually affect you decades down the road, if you live that long.
Thanks for clarifying that. When I retired, despite my misgivings, I opted for a Medicare Advantage plan, because I knew I would be out of the country for six or seven months each year, and so my outlay on premiums would be just the Part B Premium plus (currently) $16 a month for the Advantage premium. I didn’t want to be paying too much monthly, when most months I wouldn’t even be entitled to Medicare services.

This year, I thought about switching to original Medicare, and United Healthcare offered me reasonable rates on all the Medicare Supplement alternatives. I decided not to make the change in the end
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Old Oct 16th 2021, 3:55 am
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Default Re: Curious on US health insurance

I had no idea Los Angeles County owned a hospital.

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Old Oct 18th 2021, 2:56 pm
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Default Re: Curious on US health insurance

Originally Posted by ddsrph View Post
HMO’s are an excellent system that emphasizes health versus procedures. They have an incentive to keep people healthy and the set up is better suited to achieve that than regular health insurance. The fact that the US spends about twice what other first world countries spend on healthcare with poorer results seems lost on our politicians.
Personally, I would only take an HMO if it were the only healthcare policy I could get. I much prefer my PPO plan where I can see any doctor within my network with having to get a referral by my primary doctor. The PM works with me on preventive care so I don't understand where you say an HMO is better.
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Old Oct 18th 2021, 8:38 pm
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Default Re: Curious on US health insurance

Originally Posted by Rete View Post
Personally, I would only take an HMO if it were the only healthcare policy I could get. I much prefer my PPO plan where I can see any doctor within my network with having to get a referral by my primary doctor. The PM works with me on preventive care so I don't understand where you say an HMO is better.
Not all HMO's are created equal, sure I had to use a Kasier doctor and facilities, but I could self refer to most specialists, and choose my PCP within the Kaiser network, I liked it because everything was pretty much under one roof, see the doctor, pharmacy was across the hall, need an x-ray walk down the hall get it, lab same, it was nice having all services basically under one roof, and doctors being salaried means doctors are not being paid per patient so I found they didn't rush you out, for example my psychiatrists appointments with Kaiser were 1 hour, in BC they are 15 minutes because the doctors are paid per patient which means doctors need a patient assembly line.

But like anything in life, what works for one, may not work for another, HMO's were also always the lower cost option at my employers, where PPO were quite a lot more expensive, so there was the too for me.

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Old Oct 19th 2021, 5:31 am
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Default Re: Curious on US health insurance

Single payer system's are not as good as they seem at first, at least the way Canada does it, sure if I have a heart attack or stroke there will be little to not out of pocket payment, but you know I'd rather have a compregensive healthcare system and HMO's and PPO's do provide that typically, the only problem is the monthly cost, if we could find a way to lower the costs, but somehow keep the same level of access, things would be pretty good in the US.

Mental health for example, Canada its basically prescriptions, you can't really get therapy or psychological services, but US health insurance (medicaid too) covers it, they have to treat mental health more or less at parity, a single payer system doesn't have to do that.

The problem Canada did is they didn't permit private healthcare so largely not covered or covered with little inbetween options, closest is extended health, but it it meant to top up not povide coverage, as in you pay and they might cover $300 out of the year.

I would not reccomend the US switching from the system in place now to what Canada has, look towards countries with better universal systems that have more than one option, and don't leave out a massive amount of healthcare needs, heck my US healthcare always covered dental and vision too, something we don't get in Canada really, some exceptions for vision in some provinces, in my only the young and old and get vision.

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