Social security by the numbers

[brymoore]

You never know when life hits you, and in my opinion, better to be prepared for it. Everything can change over night.

Yep. I went decades without using my health insurance. I paid and paid, complained I was being used to cover older peoples health problems. I’d rather pay out of pocket, etc. I now meet my deductible within a few months each year. My attitude has changed a little about health insurance.

 

[hank4elk]

I would be completely content with a catastrophic type of plan that would cover a brain tumor, broken back, etc., and leave us to pay cash out of pocket for everything else like antibiotics, cuts etc.

I believe those kind of plans are more or less obsolete after the ACA, due to minimum coverage requirements, though are they not?

I have a catostrophic plan & Medicare. Been covered on 98% of costs. Stage 4 Cancer.
Just slid into another year of one of the medsl free, $3300/mo.

 

[Irrelevant]

I would be completely content with a catastrophic type of plan that would cover a brain tumor, broken back, etc., and leave us to pay cash out of pocket for everything else like antibiotics, cuts etc.

I believe those kind of plans are more or less obsolete after the ACA, due to minimum coverage requirements, though are they not?

idk jack about it. But I could see them saying that they need to cover the costs for the emergencies with the inflated prices for the rest of it.

Again I don't know, but it feels like if we cut out insurance completely people wouldn't be able to rack up 100k in medical debt. But even at that amount, it only equates to 4 years of premiums for our family. If my company would just set that money aside for catastrophic, then have everyone else just use pay-to-play drs, we could self insure and (I feel) come out ahead from a business and family perspective.

 

[Nick87]

idk jack about it. But I could see them saying that they need to cover the costs for the emergencies with the inflated prices for the rest of it.

Again I don't know, but it feels like if we cut out insurance completely people wouldn't be able to rack up 100k in medical debt. But even at that amount, it only equates to 4 years of premiums for our family. If my company would just set that money aside for catastrophic, then have everyone else just use pay-to-play drs, we could self insure and (I feel) come out ahead from a business and family perspective.

A guy I work with used to work for a non union contractor (no insurance) racked up a pretty significant medical bill, iirc tens of thousands of not a hundred. Owner of the company picked up the whole thing supposedly. I'd like to believe that story bit I take it with a grain of salt. Not that a good employer wouldn't do it. But pretty much everything that guy says is bullshit so who knows.

 

[Bonasababy]

I too am concerned that this may have a bad outcome. Are these going to turn out to be miracle drugs, or fen-phen 2.0?

The reason they are taking off in popularity is due to how well they work. Know several folks on them who weren't in bad shape health wise. but needed to lose weight. Serious dieting for them--no cheating for months--and they might lose a bit of weight, but they diets they were on weren't sustainable long term (and WAY less than what many people think would cause them to lose weight). GLP1 and they are losing weight--while dieting--like they have never been able to before.

This idea that some have is that it's just diet and excersize for anyone and everyone just isn't accurate. Some metabolisms in some people are tough to overcome, GLP1s have made that possible.

The caveat is whether they will eat right when they settle out at a much lower weight. If they stop the drugs and revert to eating poorly many of the benefits can be wasted. But more and more we are hearing people can stay on the drugs longer term without any ill effects.

 

[Bonasababy]

My father in law was on a hospital board for many years. He said that it was common practice to charge high prices for...say aspirin. This was so that they could recoup losses from other procedures, say a MRI, that the insurance companies would not pay the actual cost of the service provided.

This is an unending cat and mouse game between insurers and medical and dental providers. Really this applies to EVERY insurance covered loss. Those making the insurance claim, try to find and stay at the ceiling of what an insurance company will pay, on a claim. Insurance companies make decisions on how much they will pay for claims. When you think about it, it is not worth an insurance company's time and effort to push back on the price of small items.

Some years ago, I was getting a crown on one of my molars. My dentist told me directly, he was going to price it aggressively, to determine what my insurance would cover. From his business perspective, not charging the maximum an insurance company would pay, is leaving money on the table.

The only real losers are... the person paying the premiums. As I posted earlier, insurance companies have an never ending option, to assure they are profitable.

Brother is on a hospital board has been for years. Close to my PC doc too and they both sing the same thing. Blame mostly on insurance, but there are lots of other factors. The plans to cut medicare and medicaid will probably kill the small town hospital my brother is on the board for, for example.

Few know that in most places in the country, ER's can't turn people away. Guess who pays for that? The ACA in part addressed that issue, point being--health care just for me and only if I want it does NOT just effect you--we all pay for the poorly insured or uninsured.

My doctor told me that the way things are, he--a general practitioner--is costing the people he works for more than he is bringing in. He told me this in response to my concern that every podunk little practice is buying more specialized and highly expensive equipment and we have too much of that which drives our costs up. Yes he said but those are the money makers for the health system.

I also know someone who was getting by fine that was sent in to bankruptcy after a bad car accident that was not his fault but coverage wasn't enough to allow him to get by for the months it took to get back on his feet--in a different job he couldn't work the same one due to the accident. Nearly 7 years later they are getting on their feet again. In the interim while it pained them they had to go on county assistance for some years--again we all pay for that!

As bad as healthcare is, IMO Dental is far worse.

 

[Treeshark]

The plans to cut medicare and medicaid will probably kill the small town hospital my brother is on the board for, for example.

Correct, and this is an under-appreciated concern. A lot of rural hospitals get by on increased critical access reimbursement, and barely so.

If this goes (and it sounds like it will be disrupted at the very least), so do a lot of rural hospitals.

That said, we do not have a hospital shortage in the US overall- in many areas we probably have too many. But there is certainly a location problem that is likely to get worse in the short term.

 

[Letthemgrow]

Nobody likes to pay for insurance until they need it. I can tell you, it saved me from bankruptcy last year. I pay 900 per month for the top of the line medical/dental/vision. My wife spent weeks in the hospital last year. After several neurological specialists in 3 different states, they came up with a game plan. Some of her meds were 8k a month. We hit our family deductible by March and only paid $30 co-pays after that. All meds were paid for 100%, not a penny out of pocket after that for the whole family. We would have been several 100's of thousands of dollars in medical debt otherwise. You never know when life hits you, and in my opinion, better to be prepared for it. Everything can change over night.

Hope she is doing better.

 

[rjthehunter]

Nobody likes to pay for insurance until they need it. I can tell you, it saved me from bankruptcy last year. I pay 900 per month for the top of the line medical/dental/vision. My wife spent weeks in the hospital last year. After several neurological specialists in 3 different states, they came up with a game plan. Some of her meds were 8k a month. We hit our family deductible by March and only paid $30 co-pays after that. All meds were paid for 100%, not a penny out of pocket after that for the whole family. We would have been several 100's of thousands of dollars in medical debt otherwise. You never know when life hits you, and in my opinion, better to be prepared for it. Everything can change over night.

The underlined part is such a big part of this whole medical equation. It's such bullshit that these meds cost so much.

I'm not going to ask what meds your wife was on, but Mark Cuban started a business a few years back to stick it to big pharma. Cost plus drugs is the site. You can take the prescriptions there and save insane amounts of money on certain drugs. He's clear with the cost and markup on items. Some of the meds are marked up 1000% or more by most companies.

https://www.costplusdrugs.com/