Health care - administrative incompetence

banquetbear said:
...what does PPO stand for?

What is RX deductible?

What are levels 2, 3 and 4?

What is a copay?

What is an emergency room access fee?

What is 0% coinsurance?

What does out-of-network mean?

What is the A.M Best rating?
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Are you being deliberately obtuse?
 
xjx388 said:
Yup and they qualify for Medicaid for the most part, if they are supporting a family. If they aren't . . . they fall through the cracks of our current system. So yes, we need a change. Still don't see compelling evidence that a Single-payer (even with private option) system is the best solution.
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Serious question. Why are you so content with the idea that the government can pick up the tab for what the insurance companies refuse to cover/wont cover/have priced out of the range of millions?
 
xjx388 said:
Are you being deliberately obtuse?
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...I live in New Zealand.

I pay my taxes, in return I get medical care.

A few years ago my 78 year old father was diagnosed with Bowel Cancer. Two weeks after diagnosis he was in surgery and as of today my dad is fitter and stronger than I am. Out of pocket expenses: $0.

I don't have a clue what that document is saying. Why would you think I am being deliberately obtuse?
 
kellyb said:
This is just craziness.

Must. Preserve. Graveytrain. At. All. Costs. For. No. Reason.
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It's crazy that I expect doctors to get paid what they are worth? I see.

I guess you want everyone to get paid the same. It's not fair! Right?:rolleyes:
 
xjx388 said:
Uh-huh. And then you skipped all the posts where I said that there has to be some government regulation. You really should sue those teachers, they've failed you.
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So you're now against the idea of trying to create a free market in healthcare and want the US government to regulate the healthcare market to reduce/contain costs and provide universal coverage?
 
xjx388 said:
The most you would be out of pocket in a given year in that plan is 22k. And that's only if some really :rule10:ed-up :rule10: went down. An HSA (or savings account) could take care of your out of pocket expenses.

Now, what's the next issue yer going to bring up . . .
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The individual $1,000 prescription deductible is separate with an out of pocket maximum of $5,000. There's a separate deductible for mental health. I think there are others.

It also says this about the out of pocket maximum:
Annual Out-of-Pocket Limit Family:$22,500(3 family members must fully
satisfy $7,500 individual Out-of-Pocket Limit) Includes deductible.


I'm not sure what that means considering the deductible for out of network care is $45,000 (and only emergency care out of country). It sounds like if four of you incur $6,000 each, the out of pocket doesn't kick in.

There are a number of conditions that are not covered such as obesity, drug related illnesses/injuries or being injured at work.

So, really, you need to have a lot of cash on hand for this kind of policy.
 
xjx388 said:
It's crazy that I expect doctors to get paid what they are worth? I see.

I guess you want everyone to get paid the same. It's not fair! Right?:rolleyes:
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Actually, I think she was talking about the health care industry as a whole. You know, the one that is costing 16% of the GDP and benefiting very few.
 
xjx388 said:
It's crazy that I expect doctors to get paid what they are worth? I see.

I guess you want everyone to get paid the same. It's not fair! Right?:rolleyes:
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Doctor pay is a tiny part of the reason we pay twice as much as every other country.

Drug prices, lab and imaging company profits, insurance company profits, etc are where that 8% of our GPD is disappearing into.

And hoo boy, with Obamacare's mandate and subsidies, we ain't seen nothin' yet.
 
xjx388 said:
Oh yeah, I didn't like a lot of it. But I'm all for compulsory insurance and a ban on barring pre-existing conditions.
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Forcing people to buy Private Insurance is Fascism. Why should the Government force people to buy a private product? Where's the Hand of God...sorry...I mean Invisible Hand of the "Free Market" in that?

Again, you're talking out of both sides of your mouth: "The Government sucks if it regulates markets and prices, caps drug prices, bans profits on basic plans, (all the parts of the Swiss Plan you dislike), but is awesome if it forces individuals to buy Profit Based Corporate Products. Doublespeak isn't just for Stalinist Dictatorships apparently; "Friendly" Fascism (another term for Plutocracy) employs it too.

GB
 
I guess you want everyone to get paid the same. It's not fair!
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LOL.

Is xjx calling me a communist for opposing Obamacare?

This thread is so full of win. lol.
 
Gandalfs Beard said:
Forcing people to buy Private Insurance is Fascism. Why should the Government force people to buy a private product? Where's the Hand of God...sorry...I mean Invisible Hand of the "Free Market" in that?

Again, you're talking out of both sides of your mouth: "The Government sucks if it regulates markets and prices, caps drug prices, bans profits on basic plans, (all the parts of the Swiss Plan you dislike), but is awesome if it forces individuals to buy Profit Based Corporate Products. Doublespeak isn't just for Stalinist Dictatorships apparently; "Friendly" Fascism (another term for Plutocracy) employs it too.

GB
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Welcome to Mussolini's USA. Hope you enjoy your stay!

I hope xjx's wife isn't a FP or GP. The insurance companies and CMS appear to have some lovely plans in store for your future.
 
xjx388 said:
Yup and they qualify for Medicaid for the most part, if they are supporting a family. If they aren't . . . they fall through the cracks of our current system. So yes, we need a change. Still don't see compelling evidence that a Single-payer (even with private option) system is the best solution.
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No, actually a single person making minimum wage at 40 hrs a week cannot qualify for Medicaid. I should know, as I was a minimum wage worker (making pizzas) for a number of years in my 20's.

I was forced to pay out of pocket for a broken leg. I was in debt for years.

GB
 
Ivor the Engineer said:
So you're now against the idea of trying to create a free market in healthcare and want the US government to regulate the healthcare market to reduce/contain costs and provide universal coverage?
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No.

Balance, Grasshopper. Balance.

We should preserve free market principles:
Patients and doctors make the decisions
There is competition amongst doctors, hospitals and insurers
Personal responsibility for one's own healthcare

While making sure that everyone has equal access:
Compulsory insurance
No barring pre-existing conditions
Subsidies to help pay for low-incomes

What we need to do is eliminate is Medicare and Medicaid as they currently exist. As long as govt. is a payer, there will always be problems with healthcare in America.
 
kellyb said:
Welcome to Mussolini's USA. Hope you enjoy your stay!

I hope xjx's wife isn't a FP or GP. The insurance companies and CMS appear to have some lovely plans in store for your future.
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What plans would those be?
 
Gandalfs Beard said:
Forcing people to buy Private Insurance is Fascism. Why should the Government force people to buy a private product? Where's the Hand of God...sorry...I mean Invisible Hand of the "Free Market" in that?

Again, you're talking out of both sides of your mouth: "The Government sucks if it regulates markets and prices, caps drug prices, bans profits on basic plans, (all the parts of the Swiss Plan you dislike), but is awesome if it forces individuals to buy Profit Based Corporate Products. Doublespeak isn't just for Stalinist Dictatorships apparently; "Friendly" Fascism (another term for Plutocracy) employs it too.

GB
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Ah. But forcing people on to a single-payer system isn't Fascism?
 
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