OnwardandUpward

I would much prefer to be able to buy a policy which covers me for emergency/catastrophic care only and fund the day-to-day stuff myself, I think one of the weaknesses with for-profit medicine is too many diagnoses, too many procedures.

My first experience with US healthcare was when my small son broke his arm badly in England, they gave him surgery there to stabilize it and we followed up here, where insurance did not cover us as the injury happened overseas. Then Sept 11 happened, all the planes were grounded and we saw the surgeon recommended to us and asked how urgent is this, we have to go back to the UK and not sure when we can. He said the arm would fix itself over time- basically the surgery recommended was merely cosmetic because such a bad break leaves a kink in the bone for a year or two. I felt pretty sick that if the coverage had been there I would unnecessarily have subjected a small kid to yet another general anaesthesia, unnecessary, not to mention the operation cost
= $10 000. Sure enough two years later- couldn't even tell which arm had been broken.

I thought Obama was planning to cut all this and to rein in costs, but I don't see anything that will do that in ACA.

I can see my doctor ( GP ) for $60 and get her to prescribe generics for what I need ( BP ) for another $10 or $20 a month, so I would rather self-pay than have a huge premium for a $25 doctor visit two or three times a year.

Though my GP has tried to get me to go back monthly to get my prescription, another thing with for-profit...I take my blood pressure twice a day, it's perfectly managed, but the practice needs to make money so they want me to report in more often than necessary. I just said no to that, and to the 101 tests which are suggested.

Michael

+1

Unless someone has serious health issues, it is seldom worth it for someone to get anything but a HD plan.

Giantaxe

ACA Bronze plans are defined by the IRS as being HD plans that you can associate an HSA with.

robin1234

Like the NHS in some ways, but remember that Medicare recipients pay monthly premiums, potentially high out of pocket fees and/or significant premiums for a Medicare supplement plan. So Medicare is only partially funded by FICA and taxes.

scrubbedexpat091

What about those who can't afford to pay upfront and then recoup the cost? I would never be able to seek medical care if I had to pay upfront for it.

amideislas

water seeks level.

NHS: best social healthcare system in the world, but has been living beyond its means for decades (arguably, another of Labour's foolish generosity). It's inevitable that eventually it will have to implement things like co-pay prescriptions & GP visits, etc (like everywhere else on the planet), not only to help pay for its very existence, but also to minimise costly abuse of it by those who head straight to A&E or GP visit because they have a sniffle - because it's "free" <not>.

US: Traditionally, health insurance left up to employers. Health insurance not compulsory, and that's just what people are used to. Over decades has evolved into a pure money-making machine, inevitably resulting in a large portion of the population not only without it, but ineligible for it, yet insurers walking away with massive profits, whilst hospitals and clinics left paying the bill for treatment of those who can't afford insurance. This too will also necessarily evolve for the better, as this first step becomes the accepted norm in a couple of decades. Takes some getting used to.

Sally Redux

Yeah I know, wouldn't want a punitive system, maybe just at least see the bill or something along those lines.

Beaverstate

As far as your first paragraph, while not a Brit, a minor co-pay, say $30 can help with overhead and deter some frivolous visits.
Second paragraph..while I do not have excellent health insurance it has covered my needs so far. I recently had retinal eye surgery which had a list cost of $970 USD, I had a co-pay of $30...period.
The US system is 'convoluted' at best. Before Obama care AKA known as ACA the % of US population not under some form of public/private insurance was around 15%, 85% were mostly covered. Of the 15% with no coverage the majority had no major health expenditures from year to year. SOME did and couldn't pay which lead to bankruptcies which under the US system is not as catastrophic as it sounds. Not meaning to sound cold but most (not all) who went bankrupt from medical expenses were not particulary solvent to begin with.

Pulaski

They are, it is true, but even though I am strongly pro-HD insurance, I am not aware of any effort to encourage people to take such insurance. If the subject of health insurance is raised at work I will explain why we have HD insurance to my colleagues but I am not actively seeking to push it. I know of two who colleagues, independent of each other (they don't work together and as far as I know don't know each other), have come to the same conclusion, that HD is the way to go. Interestingly that is despite them having 3&4 children, which makes the fiances more marginal.

sir_eccles

I think a lot of people will end up considering silver level plans particularly if they tried gold or platinum last yr. For the ones offered in AZ it seems if you want to just pay a copay for a simple Dr visit rather than hit up your deductible, that only starts with silver. Some of these are described as point of service (pos) plans and described as a hybrid of ppo and Hmo.

nun

I can see young people going with a Bronze plan......but the older you get the more you start to think you might actually need healthcare so the lower co-pays and maybe even less expensive out of network options start to be a consideration.

robin1234

Would it have been better if they'd been married?

nun

I've just been on the website looking at plans and it looks as if I can qualify for state assistance because my income will be so low next year. Frankly it's pretty bogus because my income won't be a reflection of my net worth. So I could actually get a plan with zero deductible and a $750 out of pocket max for $78/month

Bob

Unless they don't have the savings set aside to be able to afford those premiums, whilst being able to afford the monthly rate of a policy with a lower deductible.

It can be a bit of a chicken and the egg situation for people.

Bob

It already is, unless you're in Wales, possibly Scotland? A student, pregnant or a kid and a few other exceptions such as long term care.