The fundamental problem is no body knows the cost of anything beforehand. Neither insurance company not doctors tell the cost of the care. Its really frustrating ! The first step to fix the problem is getting the cost of the care transparently. Without this i am not sure how any of the scheme works whether it is done by govt or private insurance companies !
People Lose Their Employer-Sponsored Insurance Constantly
71–80 of 246 posts
Re: People Lose Their Employer-Sponsored Insurance Constantly
#72Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan. Is the argument that switching insurance plans is stressful? What's stressful is remaining uncovered. Switching plans is hardly comparable to the transition to a Medicare-for-all program.
When I started my current job I wasn't eligible for benefits for 90 days. This is not uncommon.
My wife recently worked for a startup and had them change the company policy to start benefits on day 1 simply by asking. No one really knew why the benefits started after N days and no one cared enough to change it previously.
Re: People Lose Their Employer-Sponsored Insurance Constantly
#73Earlier quoted context omitted.
If private insurance is going to work, then every healthcare provider has to accept payment from every insurance. This clusterfuck we have where you have in-network providers with one price and out-of-network providers with a different price just has to stop. Oh you went to an in-network hospital, but this one doctor walked into the room for five minutes and she was out-of-network, so now your bill is 10x higher than…
I've always wanted to add a clause to those consent forms stating that my consent is conditional to the provider being in-network for the insurance information I provided the hospital. It is their responsibility to make that determination before they start treatment. If they provide treatment and find that they're not in network, then they forgo the right to bill for that service.
They won't let you have the procedure if you attempt to alter the agreement. I've tried!
Re: People Lose Their Employer-Sponsored Insurance Constantly
#74Pelosi is a moron who doesn't even know how the current insurance system works. Of course people lose their insurance. And ACA insurance often doesn't cover the same things as the employer-based insurance. If people need to get on Medicaid, they need to wait months before it starts, months without coverage. Everyone needs healthcare and few people can afford to pay the exorbitant costs of it in this country. And of course, if you get injured on the job, you have to fight a whole different system that shouldn't exist either. Of course Pelosi has her own insurance and plenty of money so like so many rich assholes in congress and elsewhere doesn't care and doesn't want to improve healthcare coverage for the rest of us. Let us get sick and die. Even with insurance this is often the case. Pelosi's a moron on this issue and many others. She's almost as clueless as the Republicans who get off on kicking people off of Medicaid and watching them get sick and die. How can the US even be considered a developed country anymore when we let our own people get sick and die so a few rich assholes can get richer?
Re: People Lose Their Employer-Sponsored Insurance Constantly
#75Earlier quoted context omitted.
The insurance companies have had years (decades?) to come up with one. Instead they've invested in lobbying to keep the status quo.
It mostly benefits big businesses to have employer based insurance.
He who pays the piper calls the tune [0].
[0] https://www.merriam-webster.com/dictionary/he%20who%20pays%2...
Re: People Lose Their Employer-Sponsored Insurance Constantly
#76Earlier quoted context omitted.
All other first world nations pay less. On average they pay less than half what the US pays. The fully socialized systems, like the UK, seem to trend lower in cost, as low as one third the cost of the US. But really, the takeaway should be you need universal healthcare with significant government cost controls on drugs and procedures, after that almost any arrangement of public/private administration works (but the c…
> the more private companies are in the healthcare mix, the higher the costs seem to run One worrying thing about single-payer healthcare in America is that we can look at other countries with a _rich history_ of single-payer healthcare from before the modern era [0] and see that they have developed efficient public healthcare systems, but it does not follow that our system, with its similarly rich history of for-pro…
Medicare for all plans a two year transition. There are already mechanisms to expand to set payment costs for procedures in Medicare. We would have to extend those to cover a system of setting fairer prices for drugs - as medicare is legally prohibited from negotiating drug prices currently. That's a legal precedent, not a cultural one.
But basically, future history begins today. I don't see why because we historically have an ineffective system, we shouldn't strive to build a working system.
Re: People Lose Their Employer-Sponsored Insurance Constantly
#77Earlier quoted context omitted.
We have a high-deductible health plan and live in Reno. When my gf recently had the need for a CAT scan, the first choice was here in Reno, and it was priced at over $800. She cancelled her appointment, called over in Carson City (20 minutes south of Reno), and got one done, by someone in our network, for $400. The doctor's office who referred her said, "$800? Really!?" The Reno specialist made her a follow-up appoin…
That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.
Sure, in the case of a scan that isn't urgent. If you were in a car accident and have a piece of metal embedded in your kidney are you in a level, clear-minded state to price shop about which emergency room won't gouge you?
Health care is an inelastic good, we need it. So this is a market (much like having a military) that really benefits from the government stepping in and making things sane.
Re: People Lose Their Employer-Sponsored Insurance Constantly
#78it's a shit show. I had "great benefits" at my last job accept when i needed them
1. when something happened and i needed physical therapy it turned out my copay was like 6k so i just DIY my own therapy..
2. when changing jobs i had a month gap, so i bought COBRA and 3 things went wrong.
a. it cost $1300 for a month of coverage (even with a 2k deductible)
b. since my last day was before a weekend, they actually covered my only until that same day next month, so i still had a gap of coverage (might be my employer but still sucks people have to be faced with this bs)
c. when i did go to a routine physical healthcare provider still denied the claim and i was sent a full bill. after hours of calling it turned out they initially rejected it, but then accepted months later and i was left with _*some*_ expenses ?!
Re: People Lose Their Employer-Sponsored Insurance Constantly
#79Earlier quoted context omitted.
I've always wanted to add a clause to those consent forms stating that my consent is conditional to the provider being in-network for the insurance information I provided the hospital. It is their responsibility to make that determination before they start treatment. If they provide treatment and find that they're not in network, then they forgo the right to bill for that service.
They won't let you have the procedure if you attempt to alter the agreement. I've tried!
When you go to the hospital, you just need to wear a Darth Vader mask and rasp "pray I don't alter it any further."
Re: People Lose Their Employer-Sponsored Insurance Constantly
#80Earlier quoted context omitted.
That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.
Sure, in the case of a scan that isn't urgent. If you were in a car accident and have a piece of metal embedded in your kidney are you in a level, clear-minded state to price shop about which emergency room won't gouge you? Health care is an inelastic good, we need it. So this is a market (much like having a military) that really benefits from the government stepping in and making things sane.
Not that I disagree, but the majority of health care expenses are not time-critical emergencies. I saw a statistic somewhere where it's around 15%?