Health Care Thread

Disp_sl said:

More Than 10 Million Adults Gain Health Coverage Since Obamacare Began

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I've changed my mind about the ACA. I used to be angry because I was expecting poor people to get free shit I have to pay for. It turns out that the basic, free coverage under the ACA sucks six ways to Sunday. I mean, it is just awful. You choose between shitty NPs at backwater for-profit UCs who don't care about you and overtaxed Doctors with strict time limits for billing who have longer wait lists than the VA. LOL. Get fucked poor people!

But seriously, why bother even having insurance if the only way you can get legitimate care is to wander into an ER way past the point of 'prevention' for a real trauma Doc to help you and get it for free anyway? Half the shit they simply don't treat if it can't be solved with a $4 generic.

Source: I have some employees who decided they would skip out on open enrollment to save themselves $200/month on the company family plan to 'abuse' the ACA coverage. They cannot wait to pay the $200/mo again.

It sounds like your employees went for a shitty HMO and are learning why HMO's suck - regardless of if its ACA or not. They probably went for the cheapest (which will always be an HMO) and then layered the subsidy on it.

Anything that's a PPO or better ACA or not is treated the same as standard insurance by the same provider. Distinguishing is actually quite illegal (plus reimbursement is the same, so there's no excuse to other than political grandstanding even if they chose to break that law).

Source: I have some employees who decided they would skip out on open enrollment to save themselves $200/month on the company family plan to 'abuse' the ACA coverage.

Employers get penalized if employees are receiving subsidies iirc. Also you can't just say fuck it and aca automatically puts you on the lazy piece of shit plan.

Picasso_sl said:

Source: I have some employees who decided they would skip out on open enrollment to save themselves $200/month on the company family plan to 'abuse' the ACA coverage.

Employers get penalized if employees are receiving subsidies iirc. Also you can't just say fuck it and aca automatically puts you on the lazy piece of shit plan.

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Oh, it is no doubt fraud on their part. Ithoughtthe whole thing was you can use the ACA and get Medicaid or whateverifyour employer doesn't offer, not if you 'don't want to'.

Maybe I'm mistaken about that, but whatever, the whole thing is a cluster when you make it self reporting. Apparently you can certify income level with one paycheck if you click the right boxes or something, so you can just submit a check where you called out for 3 days or the first check where you only have 1 week out of 2 because of pay cycles or something? Not entirely sure.

Maybe I'm full of shit, but whatever, generality.

Merlin 2

Palum_sl said:

Oh, it is no doubt fraud on their part. Ithoughtthe whole thing was you can use the ACA and get Medicaid or whateverifyour employer doesn't offer, not if you 'don't want to'.

Maybe I'm mistaken about that, but whatever, the whole thing is a cluster when you make it self reporting. Apparently you can certify income level with one paycheck if you click the right boxes or something, so you can just submit a check where you called out for 3 days or the first check where you only have 1 week out of 2 because of pay cycles or something? Not entirely sure.

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That might work temporarily to get it approved, but then you'd get fined at the end of the year, because they tally it with your IRS records at the end of the year from how it's written. (Might even on front end as well, but I'm not sure for that part, but they make it quite clear at the end of the year they'll double check for income changes and such and penalize those that don't on their taxes due)

Yep, and anyone who doesn't think it's going to happen is wrong. I've already had 2 households worth of clients who were removed from their health plan and put into Medi-cal this month. They've already begun the internal auditing.

Oh I've no doubt eventually things will be worked out.

But, consider also you are seeing the local impact. If there's too many people who abuse it, there will be an uproar and they'll get away with it. Just like unemployment post 2008 getting extended etc. I could see them doing emergency forgiveness/coverage/whatever if it's that endemic. Of course it could just be 1% are little shits trying to get free shit, but something tells me the number is higher than we'd all like to think.

Source: all the fat fucks on welfare driving rascals through Costco for 'lunch' at the samples counters.

On that "Costco" source - might be a Phoenix thing - samples almost go ignored out here. So lightly used that I always have to ask how fresh the samples are when I'm curious of one.

Vaclav_sl said:

On that "Costco" source - might be a Phoenix thing - samples almost go ignored out here. So lightly used that I always have to ask how fresh the samples are when I'm curious of one.

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Yea, holy shit I've never seen so many unemployed people, retired folks and 9-deep baby mommas in one place at 11 AM when trying to pick shit up for the office.

I wish we had a Costco in my area, I like to support businesses that actually pay its employees a livable wage and doesn't expect the federal government to subsidize their pay.

Palum_sl said:

Yea, holy shit I've never seen so many unemployed people, retired folks and 9-deep baby mommas in one place at 11 AM when trying to pick shit up for the office.

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Hah, ours is the opposite - 80% business types of various sorts (plumber/small business (flannel/jumpsuit) types up through suit and tie types) and like 20% soccer moms. No low class folks at ours in any real numbers.

Of course we do have a Sams Club within spitting distance of it, that the clientele scared me away from. Might just be a symptom of the Sams Club being so close.

Disp_sl said:

More Than 10 Million Adults Gain Health Coverage Since Obamacare Began

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So for two trillion dollars 3% of Americans are now covered by Obamacare? Thats impressive.

Merlin_sl said:

So for two trillion dollars 3% of Americans are now covered by Obamacare? Thats impressive.

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3% in the first year for $2T over a decade (or was it two decades?)

You do realize the "costs of Obamacare" are over the entire projection thusfar, right? So that 3% is only 5-10% of what that $2T covers. Or more in short. You're being stupid again.

Merlin has to be one of the best trolls this forum has ever seen. Either that or he is just a dumb ass.

Well as much as I hate to I guess I'm going to have to shop for a policy. Before ACA came about I had a policy I liked and it poofed Jan 1 when the ACA rolled out. Then I got company coverage but now I have to switch over to Cobra. My Cobra cost per month is $2800, I'm 43 and I was the youngest person in the company by a LOT. Lots of people 65+ and their wives who are too young for medicare or right at the line.

So apparently since my Cobra enrollment period is still open I'm eligible to enroll outside open enrollment, what a cluster fuck.

I've had my own insurance for 25 years. I was the perfect person to have on your insurance. I never made a single claim. None. My diabetes was covered after the first year on it and I paid cash for insulin, Dr. visits, any prescriptions et..because it was just easier than dicking with the insurance coverage.

Then the state got involved and offered "high risk insurance" which by law was set at 200% of the rate of a non high risk person. So instantly my insurance rate doubled overnight and I was grouped in with people that had multiple organ transplants etc... The day before it went into effect BlueCross/BlueShield was happy to cover me at 1/2 the price. When the law went into effect I still wound up with BlueCross/BlueShield at twice the premium. When the law went into effect I could no longer get private insurance, only thru the state. Prior to the passage of the law I got competitive prices fromseveral companies and I shopped around every few years, then poof why compete when the law says you now have to pay 200% of what everyone else pays. They sent me a thing once saying that almost 10% of the people were meeting their yearly maximum/lifetime maximum or whatever it was at the time and I still wasn't filing a claim. This is the first year I've ever made a claim since I was probably in middle school under my parents coverage.

Well so all that came about and then it poofed when ACA passed. I wish they would quit dicking with it. Everytime they try and help my coverage gets less and my premium goes up.

COBRA has always been terrible like that Borzak - my BC/BS through Excellus was around $2200/mo back in 2007, so with how rates have been inflating that sounds like it's right on mark with my plan that I'd had.

And Diabetes IS high risk when it comes to insurance, sorry to tell you, regardless of how much you run in it's going to previously have been weighed on its own as one of the most expensive things for insurance to cover. (Largely due to moderate cost but constant over an entire lifetime, especially if you end up needing amputations or dialysis and other extreme complications) I'd have to search for the article if you want to see the precise quote, but I want to say that it had said the average diabetes patient over their lifetime costs insurance more than all but a few types of cancer for example.

That amount of personal claims that you make really had no impact on rates, I was in the same boat because of my preexisting condition of oculodigitaldental dysplasia where I'd been seeing a doctor for physicals as work required them, and besides that I saw my doc a total of zero times until I started having my spontaneous falls.

These days there shouldn't be any "high risk" pool though from my understanding of the law, they're only allowed for a few VOLUNTARY health conditions like smoking and the like - diabetes wasn't on that list. (Disp should be able to clarify this ideally)

Got a feeling you're misunderstanding something - or that you've been going to someone to help you with insurance that's been taking you for a ride with a bit of a con game.

Except it was fine one day, then the law went into effect and suddenly I became uninsurable to any carrier in the state because the state was now setting the premium price. One day you get competitive quotes from numerous companies and the next nope, it's set by the state now. Then that poofed the day ACA went into effect but I didn't care because I got company insurance till now. Now I need Cobra.

Prior to passage of the high risk pool several years ago companies could have refused to carry me or increased the premium, but they didn't. Until the state got involved and all that went away and the price was set by the legislature instead of supply/demand and actuary tables. The ACA will eventually clusterfuck it as well.

The only thing they required in the previous 15 years was 1 year at the start of coverage before they covered my diabetes and an annual A1C. Every time I had it done the Dr. would say the same thing, my A1C was lower than a lot of fat fucks walking around without diabetes.

I've never heard of states setting premium price.