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When you are old and sick and go on welfare and are receiving food coupons and Medicaid.
I got your back, Curious George, I got your back!
I'm there Shakespeare, so give me all your money.
The Dismantling of ObamaCare - Ongoing Updates.
- Thread starter AllenChicago
- Start date
I'm there Shakespeare, so give me all your money.
The new HSA idea has potential to meet the needs of lower income folks. They have touted the idea that excess subsidies can go into the HSA account, or go to paying the higher premium for a richer plan. The poor can understand that. I agree that many of them are passing through that stage, not forever-bound in it. I was poor at one time. Raised dirt poor. Poor while putting myself through college, and poor for a few years afterward. During that time, someone explained to me what health insurance was, and I accepted their explanation. If they had explained an HSA at that time, I could have understood it, and would have considered a cheaper insurance plan in order to maximize the savings account. I could have understood it back then, accepted the explanation, and benefited from it. Being poor isn't being stupid or being unwilling to move up.
It's just that it has to fit their size. Low-income families can't take a $6,000 deductible unless they are very healthy and risk tolerant. It must be a bite they can chew.
It's just that it has to fit their size. Low-income families can't take a $6,000 deductible unless they are very healthy and risk tolerant. It must be a bite they can chew.
Buying least cost when paying OOP claims and premium has always ended with the HDHP coming out on top whenever I run the numbers. I have low claims. A licensed competent friend of mine has high claims. We have had the same plan designs since HSAs came out.
Clients and their employees choose HSAs when it is an option. The difference between higher and lower income people is that the higher fund the HSA and go to the doctor and negotiate prices. Lower income people only go when the illness is significant and they are likely to wait until they feel like they're dying. These are 2 very different levels of care.
When the HDHP is presented with a PPO or other plan and the 2 plans have the same in payroll deduction and the difference is going directly into an HSA funded by the employer, they may choose it but are always looking for ways to spend it for anything normally paid out of pocket.
Getting decent healthcare to the poor is a politically difficult issue that has expanded to the middle class who are out of the group market and above the subsidy level. I talked to a person yesterday who is only working to have group coverage because a) $12,000/yr in premium doesn't fit her budget and b) she can't pass underwriting. She has no current health issues but the past haunts.
<flame suit on> We would have money if we didn't spend twice as much as the rest of the world for military offense while not taking care of our veterans.</flame suit off>
We will always have premiums going up faster than inflation as long as we pay for healthcare with insurance and continue to have the best Congress the lobbyists money can buy.
Gotta go make money to keep the family with access to Docs. Cash is always king. Keep Ben Franklins hidden where they stay nice and clean. Moldy money is more difficult to spend.
Clients and their employees choose HSAs when it is an option. The difference between higher and lower income people is that the higher fund the HSA and go to the doctor and negotiate prices. Lower income people only go when the illness is significant and they are likely to wait until they feel like they're dying. These are 2 very different levels of care.
When the HDHP is presented with a PPO or other plan and the 2 plans have the same in payroll deduction and the difference is going directly into an HSA funded by the employer, they may choose it but are always looking for ways to spend it for anything normally paid out of pocket.
Getting decent healthcare to the poor is a politically difficult issue that has expanded to the middle class who are out of the group market and above the subsidy level. I talked to a person yesterday who is only working to have group coverage because a) $12,000/yr in premium doesn't fit her budget and b) she can't pass underwriting. She has no current health issues but the past haunts.
<flame suit on> We would have money if we didn't spend twice as much as the rest of the world for military offense while not taking care of our veterans.</flame suit off>
We will always have premiums going up faster than inflation as long as we pay for healthcare with insurance and continue to have the best Congress the lobbyists money can buy.
Gotta go make money to keep the family with access to Docs. Cash is always king. Keep Ben Franklins hidden where they stay nice and clean. Moldy money is more difficult to spend.
- 10,711
The day we turn people away at the ER, is the day we STOP having a Single Payor System.
Any discussion that does not include turning people away from the ER, is a discussion about a Single Payor System.
Any discussion that does not include turning people away from the ER, is a discussion about a Single Payor System.
Repeal EMTALA and make networks illegal will please (almost) everyone.
ER's are overburdened with people who use them for primary care. Some of that could be alleviated with onsite urgent care facilities similar to the free standing ones. Triage non-emergency through urgent care and transfer those most serious to the regular ER.
Eliminating networks can bring about price transparency, but it also makes balance billing possible and the end of OOP limits.
Single payer is not coming to the US anytime in the foreseeable future.
ER's are overburdened with people who use them for primary care. Some of that could be alleviated with onsite urgent care facilities similar to the free standing ones. Triage non-emergency through urgent care and transfer those most serious to the regular ER.
Eliminating networks can bring about price transparency, but it also makes balance billing possible and the end of OOP limits.
Single payer is not coming to the US anytime in the foreseeable future.
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RE: outlawing networks. Avoiding balance billing is the thing that we talk up for network plans. I am not in on the rationale for eliminating networks, but am open to being convinced.
There is a news story about a consulting company in the Northeast that helps physician's groups team up with other docs, one in network, one not in network, to coordinate working on a, say, complicated surgery. The in network doc gets paid some of the balance billing the out of network doc can charge. If we had no networks, this work around would not exist. Usually, the patient has no advance notice of the arrangement, and it would only work in states where this sort of thing is not outlawed. Clever in a sort of Dr. Evil way, and also understandable looking at it from the beleaguered network pressured docs POV.
In the old system, we had full medical underwriting, and the dreaded UCR. Now, there is at least some transparency with the existence of some carriers participating with the likes of Fair Health for determining their basis for UCR percentages. I describe that to clients as a sort of Kelley Blue Book for medical and dental pricing.
There is also a consumer pricing tool: https://www.fairhealthconsumer.org/
There is a news story about a consulting company in the Northeast that helps physician's groups team up with other docs, one in network, one not in network, to coordinate working on a, say, complicated surgery. The in network doc gets paid some of the balance billing the out of network doc can charge. If we had no networks, this work around would not exist. Usually, the patient has no advance notice of the arrangement, and it would only work in states where this sort of thing is not outlawed. Clever in a sort of Dr. Evil way, and also understandable looking at it from the beleaguered network pressured docs POV.
In the old system, we had full medical underwriting, and the dreaded UCR. Now, there is at least some transparency with the existence of some carriers participating with the likes of Fair Health for determining their basis for UCR percentages. I describe that to clients as a sort of Kelley Blue Book for medical and dental pricing.
There is also a consumer pricing tool: https://www.fairhealthconsumer.org/
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If Trump/Ryancare passes and doesn't work I think unfortunately that will be the next step.
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What is wrong or what is right with usual reasonable and customary URC for the region or country where the procedure is taking place?
A surgeon in California is going to charge a lot more than a surgeon in Oklahoma.
A surgeon in Panama City is going to charge a lot less than a surgeon in Mexico City or Cabo San Lucas.
So insurance premiums ought to be based on region of Medical Services provided.
A surgeon in California is going to charge a lot more than a surgeon in Oklahoma.
A surgeon in Panama City is going to charge a lot less than a surgeon in Mexico City or Cabo San Lucas.
So insurance premiums ought to be based on region of Medical Services provided.
Look, I enjoy the new administration (not Reps in general). Why to read between the lines? They published the numbers, and if you look at them, I am not sure you'll be happy either! The aspirin is not for everything. Look the spread sheets published from Kaiser and you'll see what is the promise. We'll be back at start point. People, who want $1,000 or less deductible aren't in this picture. Also you are talking politically: many republicans disagree with the proposal as well. I personally am supporting any power with good strategic thinking and planning. In this country, here are problems, which should do not be politicized, or who do it, will be badly bitten. This law can have very negative impact on the next congressional (or senate elections). So republicans should think fast and smart.
Tax Credits under the Affordable Care Act vs. the American Health Care Act: An Interactive Map | The Henry J. Kaiser Family Foundation look at the spread sheet on the upper left corner.
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URC went away with networks. Carriers pay network rates to par and non-par providers. And they pay according to where the claim is incurred.
Par providers cannot balance bill. Non-par providers can but even then on PPO plans your OOP is capped.
Premium rates are based on your zip & county on the assumption you will receive most of your care near where you live.
Eliminate networks and carriers return to URC based on historical and acquired data, adjusted for zip. Plans pay based on modified URC with no OOP caps.
Par providers cannot balance bill. Non-par providers can but even then on PPO plans your OOP is capped.
Premium rates are based on your zip & county on the assumption you will receive most of your care near where you live.
Eliminate networks and carriers return to URC based on historical and acquired data, adjusted for zip. Plans pay based on modified URC with no OOP caps.
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