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A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

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Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#71

Post by maxxxxx »

oh_sigh wrote: post #55
maxxxxx wrote: post #39

Earlier quoted context omitted.

Young people also will get old and not all of them will be multimillionaires so it makes sense that one generation pays for the previous because one day they will be in the same place.

How well does that system work for a generation that produces fewer adults than are present in the generation? Instead of paying for other peoples health insurance and then other people pay for mine, why can't I just save the money that I would be paying in premiums above and beyond what the rational amount would be and then pay for my own health care when I get older(or, pay for the higher premiums when I get older)…

Are you willing to forego medical care if you have an accident tomorrow and your savings account isn't big enough?

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#72

Post by DoreenMichele »

kevhito wrote: post #65
mobilefriendly wrote: post #27

Earlier quoted context omitted.

ACA is horrendous, unless you're receiving a government subsidy. I'm self-employed and we have one option of insurance provider, and the cheapest plan for my family last year was $18,000 a year with a huge deductible. That's after tax, out of pocket, for a healthy family with no pre-existing. Like all self-employed people I know (who aren't getting government subsidy), I moved my family to Christian Medishare, which…

$18,000 doesn't sound large, relative to the high prices we all pay. I have a good solid job, and my family plan is $24k per year. That's the most basic family plan my employer offers, but it isn't a high-deductible plan. Of course, most of that is paid by my employer, so I only pay about $4k directly out of my salary. If you are self employed, then you obviously have to pay the employer part too.

For a little perspective, I supported a family of 3 on less than $18k last year and we only had partial coverage. Even though we were homeless for most of the year, the ACA penalty is pretty painful. I am in the midst of filling out my taxes.

For a great many Americans, the figure you brush off as not particularly large is an unimaginable amount to come up with for insurance alone.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#73

Post by lostlogin »

downandout wrote: post #61

This story is couched in terms of how bad things were before Obamacare, but I’d like to point out that things aren’t great now either. To prevent Obamacare from bankrupting them, insurance companies are resorting to legally dubious mass-denials, one of which affected me personally. A few months ago, I woke up the next morning after eating some fast food and began vomiting. I couldn’t stop throwing up, and I couldn’t…

The fact that this cost that much is alarming too. I get that the staff and bed bay aren’t cheap, but the consumables for the situation you describe would probably cost less than $10, and at bulk buy prices perhaps on a couple of dollars.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#74

Post by tptacek »

mobilefriendly wrote: post #66
tptacek wrote: post #56

Earlier quoted context omitted.

As I understand it (I hope I understand this, because I rely on it), LLC principals are allowed to deduct the cost of health insurance.

Unfortunately neither Christian Medishare nor our out-of-pocket health care payments are deductible. https://www.medishare.com/blog/is-healthcare-sharing-tax-ded...

Any HN conversation that starts out as a debate about Obamacare and ends up saving someone a few thousand dollars a year is a good conversation, so you are very welcome.

Health insurance prices are a nightmare. Please don't let me come off as sounding like I don't think they are. The goal of the ACA was fix that problem, and though it fixed some very important problems, it surely didn't fix that one.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#75

Post by spost »

mobilefriendly wrote: post #46
tptacek wrote: post #42

Earlier quoted context omitted.

I'm sorry you feel that way, but that's simply not what happened. I cofounded a company that provided insurance to ~40 full-time employees (and provided insurance before the ACA was passed ), and the costs you're seeing today are in line with where costs were outside the ACA and prior to the ACA. No matter what you think about prices, though, the most important thing the ACA did was create a nationwide requirement fo…

It isn't what I think about prices, it is the facts, ACA exchanges up 34% YoY. https://www.cnbc.com/2017/10/25/most-popular-obamacare-plans...

Nobody upthread of you is arguing that health insurance prices did not go up after the implementation of the ACA. The argument is that the rate of increase has decreased. I don't know if this is true, and don't have data to argue one way or another, but you and the other people in this thread are arguing about different numbers.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#76

Post by jacobolus »

DoreenMichele wrote: post #64
tptacek wrote: post #59

Earlier quoted context omitted.

That article, aided and abetted by the terrible writing in the Brookings article it's criticizing, is comparing apples (the rate of increase ) and oranges (the actual increase ). There's no controversy that health insurance rates are increasing; they've been increasing dramatically since the turn of the century.

And I actually worked in insurance. The Fortune 500 company I worked for paid for me to go to school 8 hours a day for 3 months. I got a certificate from a technical college and additional training. Obamacare is a terrible solution. But don't let industry expertise stop you from your usual antics of feeling like no one is allowed to disagree with you and you need to win every argument, even if it means harassing anyo…

Please don’t adopt this kind of hostile style. It wrecks the whole conversation.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#77

Post by kevhito »

mobilefriendly wrote: post #63
jjoonathan wrote: post #51

Earlier quoted context omitted.

How do you make sure you're actually getting catastrophic coverage for $3k? The information asymmetry between insurance providers and customers heavily incentivizes the creation of "value" plans that achieve their "value" by appearing to cover more than they actually do. Since only a tiny fraction of customers ever make catastrophic claims, most people will be unaware that they are buying garbage even if a policy wer…

Last year I didn't care because I couldn't afford the ACA, and Christian Medishare met the Obamacare requirement to carry insurance or face a tax penalty. The "health care sharing ministry" operates differently than insurance, my concern isn't denial of coverage but that the entire enterprise will collapse. https://en.wikipedia.org/wiki/Health_care_sharing_ministry

I'm not totally clear on the different situations here. I thought the tax penalty was only about $3k for even fairly wealthy families (family of 4, $150k/yr salary). It sounds like you felt you couldn't afford ACA insurance ($17k) and couldn't afford to pay the penalty either, so you went out and purchased $3k of "insurance" you don't actually have any faith in and didn't really want. Am I confused about the penalty amounts? Or you just felt that if you were going to pay $3k, you might as well give it to Christian Medishare?

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#78

Post by oldandtired »

Healthcare is a basic infrastructure problem, not that it is considered this. As a basic infrastructure problem, there are many who see a profit to be made in supplying services. Each country views healthcare from a specific point of view and that dictates how they will, as a country, provide the general healthcare service.

A country like the USA see this in the light of healthcare as a business, make as big a profit as you can, irrespective of the actual services that you provide. In other countries where the relevant governments provide universal service they allow private businesses to dictate the price that the government pays for the supplies required.

So, we have general commodities when supplied into the healthcare system being charged at 10x or greater for on item which, if not used in a healthcare environment, is charged a much lower price. This applied to things like computers, phones, chairs, tissues, matches, paper, toilet paper, gloves, etc,

The suppliers get away with this because of the perception that these goods are of a higher quality. These goods often come off the same production lines as those sold in a normal commercial market.

I have seen up to date medical equipment that cost a large fortune that looked pretty, but if you actually looked at the basic equipment was technology that was anything up to 10 years old and was superseded by stuff your could get commercially.

The amount of money charged for drugs is based on the amount of money spent of research, which if you actually looked at the figures thrown about were spent by the public purse not the private.

It is a captive market and those supplying into it want it that way to maximises their profits. Morality questions are not considered to be important unless it has regulatory considerations that will significant reduce your profit margins if you fail to live up to them.

The problems within the healthcare system (insurance included) will not be solved any time soon. Even if there was a revolution that changed the entire basis of how and when healthcare was supplied, it will soon return to what we see today as greed is the basic motivator for society as a whole.

To bring about real change requires people really changing and this will not happen because we are basically looking out for ourselves and our own. This occurs on the local level, on the regional level, on the state level and on the national world levels.

The healthcare system is an area that needs a complete overhaul worldwide. It is not going to happen since most people do not have the ability to see past their local situation.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#79

Post by tptacek »

dustingetz wrote: post #68
tptacek wrote: post #56

Earlier quoted context omitted.

As I understand it (I hope I understand this, because I rely on it), LLC principals are allowed to deduct the cost of health insurance.

my accountant never allowed me to do this in PA

As I understand it, and your accountant is an expert while I am not, you have to be actually self-employed --- not moonlighting or doing side-work, with your money all coming in through the LLC --- and your spouse can't be eligible for group coverage through their job.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#80

Post by John_KZ »

justinmk wrote: post #3

I've begun to suspect is that "universal healthcare" means "you weren't denied, you're just on a waiting list, and every physician is an interchangeable cog". I often wonder why health insurance companies don't use a similar tactic. Edit: Try finding a pediatrician in Berlin. (Seriously, I would love to hear recommendations)

Waiting lists for doctors can be long for non-emergencies. This applies to most countries with a public health system. Typically they are prioritized based on need, not money. Also arranging regular appointments weeks/months before allows for less downtime in the doctors office thus cheaper healthcare. It's annoying but it works.

Also Germany suffers from an ageing population which is why there aren't that many experienced professionals of any kind.

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