Obamacare 5 years later. Crow, anyone?

[Nihilianth]

Wait! 5 years already!? I could have sworn it was just passed yesterday, and we were still debating on the merits of how terrible of a law it is!

Gosh. Five years. Time really seems to get moving, the older you get. I'm 31, and not looking forward to another decade....

Anywhoo, that's my rant for this thread!

 

[Ambrosia]

From what I've heard Canada and the UK have a horrible health care system. Its going to be a long process towards the abyss.

I can't speak for Canada but I live in the UK and you have most definitely heard wrong.

Here if I get sick I go to the GP and they prescribe medication, I pay a fee for the prescription but the GP visit is free. If I break my arm or do something a bit more serious that needs immediate care then I can go to an A&E dept and be treated within a few hours (or immediately if it's serious enough)

If something really bad happens some nice people in an ambulance will turn up after I call the emergency number and scoop me up and take me to hospital. Usually pretty quickly.

If I discover I have some serious disease that requires lengthy/complicated treatment then I get lengthy and complicated treatment. Sometimes I might have to wait a while before this can happen.

Apart from fees for prescription medication I have to pay exactly £0 for all of this.

If I decide that I don't want treatment via the NHS and want private treatment, which is usually faster, then I can choose to buy health insurance from one of several companies. The health insurance ads show people being cared for by younger prettier nurses than seem typical in the NHS in gleaming private suites, with the latest and greatest snazzy equipment, but the reality of private healthcare here probably isn't quite as polished.

It's not the best system, and the NHS could use a lot more funding, (apparently our government can only find that kind of funding for bankers, but that's a different thread) In recent years A&E departments are getting fewer and further between for example.

It still boggles my mind that a system broadly similar to this whereby if you get sick you get treatment and don't have to pay for it yourself, isn't the norm in every industrialised country.

I pay slightly higher taxes than Americans do, but not having to pay for health insurance means it probably works out about even in the end.

 

[Border Reiver]

I heard it from someone from Canada and an american who lived in the UK.



She literally had to operate on herself because she couldn't get to see a doctor.



UK sucks and their health care sucks too. Canada isn't even a real cocuntry its more like America's unofficial northern territory.

Ah, unsupported third hand anecdotes with no dates, coupled with an insult.

In short, nothing of worth.

 

[The Don]

I can't speak for Canada but I live in the UK and you have most definitely heard wrong.

Here if I get sick I go to the GP and they prescribe medication, I pay a fee for the prescription but the GP visit is free. If I break my arm or do something a bit more serious that needs immediate care then I can go to an A&E dept and be treated within a few hours (or immediately if it's serious enough)

If something really bad happens some nice people in an ambulance will turn up after I call the emergency number and scoop me up and take me to hospital. Usually pretty quickly.

If I discover I have some serious disease that requires lengthy/complicated treatment then I get lengthy and complicated treatment. Sometimes I might have to wait a while before this can happen.

Apart from fees for prescription medication I have to pay exactly £0 for all of this.

If I decide that I don't want treatment via the NHS and want private treatment, which is usually faster, then I can choose to buy health insurance from one of several companies. The health insurance ads show people being cared for by younger prettier nurses than seem typical in the NHS in gleaming private suites, with the latest and greatest snazzy equipment, but the reality of private healthcare here probably isn't quite as polished.

It's not the best system, and the NHS could use a lot more funding, (apparently our government can only find that kind of funding for bankers, but that's a different thread) In recent years A&E departments are getting fewer and further between for example.

It still boggles my mind that a system broadly similar to this whereby if you get sick you get treatment and don't have to pay for it yourself, isn't the norm in every industrialised country.

I pay slightly higher taxes than Americans do, but not having to pay for health insurance means it probably works out about even in the end.

Here in the glorious People's Republic of Wales we don't even need to pay for our prescriptions (or parking in hospitals).

My Father who has no car is taken, free of charge, the 15 miles to his local hospital for routine appointments by some wonderful, friendly, volunteers in their own very comfortable cars.

I also pay next to nothing for dental treatment (we're underpopulated enough to have NHS dentists vacancies) IIRC my annual checkup, xrays and dental hygienist visit is under £20, a couple of years ago I had a filling replaced and I think it was a tad under £50.

My ACL repair that I had done in January was, IMO, expertly done. I can now comfortably run 5 miles and I have just finished a course of physiotherapy, again at no charge to me. I could have continued the physio longer but I didn't see the need but if I encounter any problems I can book another appointment of set of treatments.

I wish that the U.S. had a system as "horrible" as this which costs around half of what they are paying

 

[twinstead]

I wish that the U.S. had a system as "horrible" as this which costs around half of what they are paying

Commie!

 

[paulhutch]

BTW: I called the former case worker and she told me that if the name is in the system you have insurance. That was her way to get me off the phone. "He's in the system, there's no more I can do. If the doctors don't accept the insurance I can't help." "Even if the doctor says he accepts my son's chosen plan?" I asked. Even then.

In that situation you need to say, "they have not received their ID cards". This will trigger her to send out replacements or dig deeper in the system/ask a supervisor and see that there is a problem. For the nearly 40 years I've paid for health insurance the one thing that's always been said by the insurance company and HR is make sure you've received your ID card, without it you have no proof of coverage. I get this warning every time new cards are first issued and then a reminder from HR a couple weeks later usually of the format; "If you haven't received your ID card contact us immediately".

I'm assuming your kids are both over 18, if not that could be the cause of the screw ups, companies/government agencies don't like to make contracts with minors they prefer to make the contract with the legal guardian. Also as a last resort, if the kids are under 26 years old you could have them added to your health insurance plan.

 

[RandFan]

In that situation you need to say, "they have not received their ID cards". This will trigger her to send out replacements or dig deeper in the system/ask a supervisor and see that there is a problem. For the nearly 40 years I've paid for health insurance the one thing that's always been said by the insurance company and HR is make sure you've received your ID card, without it you have no proof of coverage. I get this warning every time new cards are first issued and then a reminder from HR a couple weeks later usually of the format; "If you haven't received your ID card contact us immediately".

I'm assuming your kids are both over 18, if not that could be the cause of the screw ups, companies/government agencies don't like to make contracts with minors they prefer to make the contract with the legal guardian. Also as a last resort, if the kids are under 26 years old you could have them added to your health insurance plan.

Thank you very much. Both over 18. Both went to different offices. IMO: Though anecdotal, I suspect that the program is taxing the system and putting pressure to get more people into the system than before without increasing staff.

My oldest son said he spoke to someone at his HR today and she thinks that both my sons were signed up under the already existing block-grant Medical program for retirees and those on disability (oddly enough it's simply called medical).

Seems that since Obamacare passed there is a new state-exchange Medical program in Los Angeles for those not retired or on disability. That program is called LA Care. The two programs use separate databases and the data input people are used to using the old system. so data gets keyed into the wrong system. If the paperwork isn't properly identified at the time of application it is likely to go into the wrong system.

Here's the kicker. The department does not seem to distinguish, in house, between the two programs. They call both "Medical" and that, according to the woman at my son's work is the source of the problem. You don't know that you don't qualify for the shiny new coverage until you try to use it.

A bit of good news. My son was advised to ask for a refund of the penalty as he has proof that he acted in good faith. Hopefully both sons can do that.

I guess the take home here is that you must vigilant and if you don't get an insurance card in the mail within a month or two you must go back and do it all again.

 

[Nihilianth]

I hate to be the bearer of bad news but....

Both of my sons signed up for Obamacare over a year ago. Neither have ever had it. Both were told they had it but when they went to a doctor they were both told, seperately, that they were canceled. Both have been to many appointments and both have been fined for not having insurance. Both have letters of acceptance (doctors do not accept letters of acceptance).

In January my youngest son made an appointment with his insurance rep who laughed and told him to change doctors because since he was in the system obviously the doctor's office must be incompetent.

My son changed doctors. He was told again that he didn't have coverage. He made another appointment with the case worker. She quit. Both have been to the whitehouse site numerous times. I've written letters. My kids have written letters. I've called on their behalf (I was told to have them come in).

So, my son made an appointment. Showed up on time. Was told that the appointment was cancelled.

If anyone has any advice, I'm pro Obamacare, I'd happily listen.

• My youngest is currently unemployed.
• My oldest works at Target and does not qualify for their insuance because he works less than the minimum to get benefits.

Ya know, I ended up paying the fine this past year. I was INCREDIBLY surprised. I picked up insurance with BCBS through my state's exchange (PA.) But when my taxes were done last month, I owed $300 for the fine.

I called BCBS to find out what in the heck was going on, and they said I was never covered last year. I told them I went to the doctor once for a typical check-up, and they accepted my insurance, and I made the co-payment ($50.) I was told there was no record of me having insurance through the exchange at BCBS. I checked through all my financial records of that year, and noticed $100 was taken out of my checking account back in the spring of '13, paid to BCBS, but then a week later it was returned!

My god, I did not remember this ever happening.

Then it got even stranger. I went to my doctor's office, and asked about the $50 co-pay I paid at the end of '13. And they had no record of that either! I had to go back to my bank, and found the $50 I paid to the doctor's office, took it to them, and they were then able to dig up the record of teh $50 from me, as well as the other $75 that BCBS paid to them!

I just laughed. The lady thought I was nuts, I swear. I just let it go. I did get my $100 back from BCBS from when I signed up, and not going to press them about the $75 they supposedly paid to my doctor. I paid the stupid $300 fine, because I got a new job this past December, and am on my employer's plan. Which is a solid plan. And it is again through BCBS.

 

[Nihilianth]

That's strange. Canada's Healthcare is going fine. My family lives in Canada. They have no problems getting good, and timely healthcare without going bankrupt trying to pay for it.

You hear wrong. You have no argument you lose.

Ya know, you responded to a person who said this:

" Canada isn't even a real cocuntry its more like America's unofficial northern territory. "

Just sayin'.

 

[Tsukasa Buddha]

Why, yes, OP, five years into Obamacare and it does feel like I'm under the shackles of Jim Crow laws.

 

[ponderingturtle]

The fact that I was generally against the law doesn't mean I have (or had) a black and white view of some its benefits or that I would outright favor repealing the thing without considering the consequences if it's done recklessly. The Ted Cruzes of the Republican party tried to repeal it without a plan of action and just as the law took full effect. It would have been utter chaos for that to have happened, so yes I'd like the law changed to better suit matters but no, I'm not interested in repealing the law just for the heck of it. Now, my next question is will you read my responses and respond with productive criticism, or are we going to continue ignoring the substance and run with the stereotyping and mind reading? I'm afraid I don't have any interest if it's going to continue with the latter.

My problems with the prior status quo and the current one, is when I have to deal with urgent care check ups that cost $700 for 10 minutes, two X-rays, and a foot wrap to go home with. Insurance premiums are skjy high because health care costs are sky high, and the ACA ttries to address this by spreading costs through taxation and cost sharing, which is nice and puts a bandaid on it, but doesn't stop the inflation. And some of the European insurance systems have had similar issues where the funding is still hit because of the cost factor from the treatments and medicines themselves, and as well, based on an aging population impacting the capability of younger insured to carry the cost burden.

Of course not, the inflation is all good because it comes from free enterprise that are highly profitable. You want the government to start limiting the profits a person can make from their business? What kind of rampant socialist are you?

Nothing can be done about the costs of health care because the profits from those high costs are being spent fighting the kind of socialist regulations that could actually do something about it.

 

[ponderingturtle]

That's strange. Canada's Healthcare is going fine. My family lives in Canada. They have no problems getting good, and timely healthcare without going bankrupt trying to pay for it.

And yet you fail to see the moral hazard of being able to get sick with out going bankrupt that the rejection of which Americans bootstrap mentality is built on.

 

[mike3]

I'm going to guess that you are young. Have you ever looked at an itemized hospital bill? How quickly do you think you could "put aside" $50,000 or $80,000 for two or three day stay in the hospital? Health insurance isn't just about going to the doctor once in a blue moon or the occasional antibiotic. If you had a really serious illness, injury or disease, you might as well forget it. What if you're in a car crash and require multiple surgeries and months or years of therapy, lots of drugs and medical equipment? You can't pay for that yourself. Very few people can. The bitter irony of having state-of-the-art medical technology is that it comes at state-of-the-art prices.


One of the criticisms of the ACA is that it would be socialized medicine, which it isn't.

So what would you suggest such a person should do, where if they make more than the medicaid limit, they have to pay, but that payment might cut into their income so much that the amount of money they have left over is less than what they had before the raise?

 

[RandFan]

So what would you suggest such a person should do, where if they make more than the medicaid limit, they have to pay, but that payment might cut into their income so much that the amount of money they have left over is less than what they had before the raise?

Welcome to the real world. We live in a society. The idea that there is a system free of dilemma in social communities of people possessed of compassion and empathy is like living in the ocean without means to breath oxygen.

There are a lot of things that citizens must do because we have to write policies for everyone. I can't take something from the store without paying for it simply because I'll pay later. I'm an honest guy but society doesn't make laws just for me.

 

[Shalamar]

Ya know, you responded to a person who said this:

" Canada isn't even a real cocuntry its more like America's unofficial northern territory. "

Just sayin'.

Oh. I know. And yet, Canada has Universal Health Care, practically a socialist nation! Yup! Just like the good old US of A...

Though there are things that (some) Americans would be envious of Canada for.. Like having an official language (or two)..

 

[Shalamar]

And yet you fail to see the moral hazard of being able to get sick with out going bankrupt that the rejection of which Americans bootstrap mentality is built on.

Considering that I am a result of the Canadian Health Care system (My parents were poor when I was born, and I was very very sick), I'll take the moral hazards!

 

[ponderingturtle]

Considering that I am a result of the Canadian Health Care system (My parents were poor when I was born, and I was very very sick), I'll take the moral hazards!

Well many people fail to understand that it is not possible to pull yourself up by your boot straps, if you can not afford boots.

 

[Emily's Cat]

BTW: I called the former case worker...

Just for clairification, when you say your sons have Obamacare, do you mean that they have private insurance through an Individual Market exchange, or do you mean they have Medicaid? There's a massive unending pile of differences between the two.

 

[GodMark2]

Just for clairification, when you say your sons have Obamacare, do you mean that they have private insurance through an Individual Market exchange, or do you mean they have Medicaid? There's a massive unending pile of differences between the two.

Especially if you happen to live in a state that fought tooth and nail to avoid being forced to implement the expanded Medicare/Medicaid provisions of the ACA.

 

[Smackety]

It like thinking you own a car when: a.) you did not pay for a car, and b.) there is no freaking car!