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Featured Replies

6 minutes ago, Sawbonz said:

I have never taken the time to try it, but it looks like in Texas at least if the cash price you pay for a covered service is less than the in network allowable, you can submit the receipt to the insurance company and have them apply it towards your out-of-pocket

That is extremely useful information. Thanks.

16 minutes ago, Anastasis said:

That is extremely useful information. Thanks.

Ditto X thousands

18 hours ago, Nice Guy Eddie said:

But there are also surveys where a high percentage of people rate their insurance as excellent or good. It’s like Congress ratings. People universally hate Congress but a majority like their own rep.

and while many seem to want Medicare for all, Medicare is really great because it’s highly subsidized by younger taxpayers. I’ve never seen one analysis that describes the costs of all of those younger people being moved into Medicare. Not to mention that Medicare would need to open up more coverage for areas that they never/rarely cover like pregnancies or children’s health.

and finally hospitals and doctors depend on the higher reimbursements from insurance other than Medicare and Medicaid. We can tell them to suck it up and accept less revenue but there are negative impacts to Medicare for all.

Exceptional people should be able to create an exceptional health care system for its people. It remains to be seen if the negative impacts of Medicare for all outweigh the positives.

3 hours ago, Satchel said:

Exceptional people should be able to create an exceptional health care system for its people. It remains to be seen if the negative impacts of Medicare for all outweigh the positives.

do you work in the pharma world, by any chance?

3 hours ago, Satchel said:

Exceptional people should be able to create an exceptional health care system for its people. It remains to be seen if the negative impacts of Medicare for all outweigh the positives.

A key component would be how is the situation handled when someone WANTS to stay out of Medicare for All. Will they be given a tax break or refund if they pursue health coverage on their own, or through their employer? I'm not asking you for the answer but I'm curious if this is optional or the only method for coverage.

Personally I don't think that I've ever had insurance coverage through my employers that is worse than Medicare. Why should I switch to have worse coverage?

3 hours ago, Satchel said:

It remains to be seen if the negative impacts of Medicare for all outweigh the positives.

“Medicare for all” is a phrase that is not specific to one proposal. To what are you referring here?

43 minutes ago, Nice Guy Eddie said:

A key component would be how is the situation handled when someone WANTS to stay out of Medicare for All. Will they be given a tax break or refund if they pursue health coverage on their own, or through their employer? I'm not asking you for the answer but I'm curious if this is optional or the only method for coverage.

Personally I don't think that I've ever had insurance coverage through my employers that is worse than Medicare. Why should I switch to have worse coverage?

I think one key component to all "universal healthcare" plans is that employer-sponsored insurance will no longer be a thing.  So you'll be paying full-boat, not some percentage of the actual cost.

And, like most general-welfare things, property taxes, etc., opting out is probably not going to give you a tax break.

1 hour ago, Nice Guy Eddie said:

A key component would be how is the situation handled when someone WANTS to stay out of Medicare for All. Will they be given a tax break or refund if they pursue health coverage on their own, or through their employer? I'm not asking you for the answer but I'm curious if this is optional or the only method for coverage.

Personally I don't think that I've ever had insurance coverage through my employers that is worse than Medicare. Why should I switch to have worse coverage?

You couldn’t be allowed to opt out, it wouldn’t work.  There would be supplemental plans from private insurers.  And I’m sure cash pay concierge doctors would become more popular.

5 hours ago, Longhorn_Fan68 said:

do you work in the pharma world, by any chance?

No. I hate big pharma.

16 hours ago, TwiceHorn said:

I think one key component to all "universal healthcare" plans is that employer-sponsored insurance will no longer be a thing.  So you'll be paying full-boat, not some percentage of the actual cost.

And, like most general-welfare things, property taxes, etc., opting out is probably not going to give you a tax break.

 

16 hours ago, Snake Diggity said:

You couldn’t be allowed to opt out, it wouldn’t work.  There would be supplemental plans from private insurers.  And I’m sure cash pay concierge doctors would become more popular.

You do know that over 50% of senior citizens use a Medicare advantage plan which is a private insurance plan except it just has the name Medicare in it. It’s branded as Medicare and has nothing to do with govt other than they approved of the plan. And this is the direction that more and more senior citizens are going because of costs. Govt run Medicare is too expensive for them.

If Medicare for all is actually Medicare Advantage for All, it’s no different than calling it Cigna (or Blue cross) for All.

and FYI, Medicare advantage plans are considered much worse than traditional Medicare from a care perspective.

9 minutes ago, Nice Guy Eddie said:

 

You do know that over 50% of senior citizens use a Medicare advantage plan which is a private insurance plan except it just has the name Medicare in it. It’s branded as Medicare and has nothing to do with govt other than they approved of the plan. And this is the direction that more and more senior citizens are going because of costs. Govt run Medicare is too expensive for them.

If Medicare for all is actually Medicare Advantage for All, it’s no different than calling it Cigna (or Blue cross) for All.

and FYI, Medicare advantage plans are considered much worse than traditional Medicare from a care perspective.

Saying Medicare Advantage plans have nothing to do with the government is a highly misleading statement. They are funded by the government and overseen by CMS. There’s a lot of government involvement in those plans.

Otherwise, yes, I agree that Advantage plans are a scam to funnel money from public good to private enterprise and shareholders. My parents are on traditional Medicare and my in-laws have a Medicare Advantage plan and the experiences between the two when it comes to access and quality of care could not be more different.

  • 2 months later...

Health care costs case study, Rx domain:

10yo male, screens well for ADHD, after much consideration want to test stimulant treatment. 

Doc Rx is for some version of Vyvanse. $190 a month.

Fuck that shit. 

Send doc message, hey doc that shit is $6 per day. How about we try some Adderall XR generic or just straight up methylphenidate generic. Either way less than a quarter a day. First trial of stimulants, they are all interchangeable at this point. 

Revises script to some branded form of methylphenidate, with a discount card that gets it down to $2.50 a day. 

Bangs head against wall. 

This is one example of why we can't have nice things. 

 

Get to test out our health coverage, thanks to a lacerated kidney soccer injury that had some ER time and a couple of nights in icu. First time our family has really racked up some big bills since labor and delivery 16 years ago. Exactly, as he spent his birthday in the hospital. 

  • 3 months later...
  • 2 months later...
  • 2 months later...

My wife’s supplemental Medicare premium is going up $60 a month in January.   For us, it’s a blip on the radar but for many that will hurt. 

On 1/6/2025 at 5:06 PM, TwiceHorn said:

I think one key component to all "universal healthcare" plans is that employer-sponsored insurance will no longer be a thing.  So you'll be paying full-boat, not some percentage of the actual cost.

That is a key feature, maybe THE key feature of any reform that seeks improvement to the private health insurance market, not a bug. All employees are ALREADY paying the full boat cost, they are just bartering some amount of their labor for it and giving their employer the entire tax break, in return for a suboptimal risk pool and no portability.

18 minutes ago, Bozo_Casanova said:

That is a key feature, maybe THE key feature of any reform that seeks improvement to the private health insurance market, not a bug. All employees are ALREADY paying the full boat cost, they are just bartering some amount of their labor for it and giving their employer the entire tax break, in return for a suboptimal risk pool and no portability.

You’re not wrong, but let’s not pretend that employers would pass on any savings to labor.

3 hours ago, VABuckeye said:

My wife’s supplemental Medicare premium is going up $60 a month in January.   For us, it’s a blip on the radar but for many that will hurt. 

Mine was about $30

45 minutes ago, royiv said:

You’re not wrong, but let’s not pretend that employers would pass on any savings to labor.

You act like that’s a bad thing. Healthcare is the single biggest factor that prevents people from seeking better employment, choosing to live on one income instead of two, or starting businesses of their own. When employers can’t handcuff their workers with healthcare, wages are the primary tool they have to keep them, and if they choose not to pay market rate, they will suffer the consequences.

Don’t confuse bondage with benefit.

Edited by Bozo_Casanova

2 hours ago, Bozo_Casanova said:

You act like that’s a bad thing. Healthcare is the single biggest factor that prevents people from seeking better employment, choosing to live on one income instead of two, or starting businesses of their own. When employers can’t handcuff their workers with healthcare, wages are the primary tool they have to keep them, and if they choose not to pay market rate, they will suffer the consequences.

Don’t confuse bondage with benefit.

My man, you are so out of touch with the hourly wage earner in America. You’ve lost the plot if you think healthcare is what keeps hourly workers from seeking better employment. Healthcare is pretty far down the list when you’re making a wage that makes you eligible for Medicaid.

5 hours ago, royiv said:

My man, you are so out of touch with the hourly wage earner in America. You’ve lost the plot if you think healthcare is what keeps hourly workers from seeking better employment. Healthcare is pretty far down the list when you’re making a wage that makes you eligible for Medicaid.

I’m pretty clearly not talking about Medicaid eligible hourly workers, I’m talking about everyone above the upper income cutoff, but still, something like one in six workers would quit their jobs but stay there to retain healthcare benefits.

I hardly think it’s good for hourly workers to depend on their employers for their health and life in addition to income. But it’s also bad for the economy and entrepreneurship, in addition to depressing wages:

  • Americans are willing to endure unfulfilling work (38%), limited career advancement (28%) and difficult coworkers (26%) to retain employer-sponsored health care coverage.

  • Employees are willing to endure high stress (24%), long hours (26%), poor work-life balance (15%), low pay (12%) and even bad bosses (14%) to retain employer-sponsored health care coverage.

  • The risk of losing employer-sponsored health insurance deters nearly half of full-time employees (45%) from pursuing self-employment.

  • Over half of Gen Zs (55% of respondents under 26) are concerned about their future health coverage.

  • Over one in 10 self-employed Americans say they won’t have health insurance coverage in 2024.

  • Close to three in 10 admit that employer-sponsored health insurance could entice them to leave self-employment

Edited by Bozo_Casanova

10 hours ago, Bozo_Casanova said:

That is a key feature, maybe THE key feature of any reform that seeks improvement to the private health insurance market, not a bug. All employees are ALREADY paying the full boat cost, they are just bartering some amount of their labor for it and giving their employer the entire tax break, in return for a suboptimal risk pool and no portability.

Well, they don't actually pay the full, minimum they get 50%. And upper level employees get up to 100% including family. But the key here is the suboptimal risk pool. It hurts everyone.

I have said for years, as a business owner, I am basically a single issue voter for government healthcare. I hate dealing with healthcare so much I can't even begin to articulate it.

1 minute ago, G650 said:

Well, they don't actually pay the full, minimum they get 50%. And upper level employees get up to 100% including family. But the key here is the suboptimal risk pool. It hurts everyone.

Indeed, and also the duplication of administrative work, often sloppy irrational plan decisions, perverse incentives, price distortions, all the middlemen, etc.

5 minutes ago, G650 said:

I have said for years, as a business owner, I am basically a single issue voter for government healthcare. I hate dealing with healthcare so much I can't even begin to articulate it.

Btw, do you work with a broker, or are you going the OneDigital/Sequoia PEO solutions route?

1 minute ago, Bozo_Casanova said:

Indeed, and also the duplication of administrative work, often sloppy irrational plan decisions, perverse incentives, price distortions, all the middlemen, etc.

ice-t hater GIF

Just now, Bozo_Casanova said:

Btw, do you work with a broker, or are you going the OneDigital/Sequoia PEO solutions route?

A broker. Who actually is a distant relative of mine. And I can't say anything bad about them, they do a good job with what they do, but the fact that the job needs to exist at all is the issue!

5 minutes ago, G650 said:

the fact that the job needs to exist at all is the issue!

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