Pipe dream? Obamacare

[mac]

I think that deductibles are a good idea because they send an economic signal to consumers that medical care is not free. Imagine that, I support, strongly, using market forces. Only CB seems to have noticed.

[coboardhead]

Exactly Mac...

This is damned if you do and damned if you don't. HSAs were developed under the Bush Administration to encourage the use of larger deductible plans to increase consumer responsibility...a very good thing. That this is integral to the ACA is a good thing.

That we force the health care system to attach costs to the product and reducing cost shifting...a very good thing. It is better to subsidize directly than obscure the realities of the costs.

That the law encourages more of the population in participating in the insurance pool....a good thing.

These all sound like Republican ideas to me!

[boggsman1]

CB...the HSA's were an achievement for Bush, BUT, the insurance companies dont like them so guess what? Most large companies don't offer them anymore.
NW...the emergency room is not the answer. I will happily subsidize those less fortunate , in order for them to have healthcare. It also will help the economy, which will in turn help me.

[coboardhead]

Boggsman...I have not run into larger insurers not providing high deductible HSA's. I know that Aetna, Humana and Assurant still do.

[swchandler]

NW30, for a conservative, I'm a bit surprised by your last post. You seem to be suggesting that folks shouldn't be responsible for themselves. Let me say up front that I've been choosing a high deductible plan with an HSA for many years now, because the monthly cost for such plans are far less expensive than managed care plans (about 1/4 the cost). Sure, I have a $2000 deductible, but the way that I look at it, I'm going to be spending that money anyway because of my medical condition, and I would much prefer having that money being tax deductible. Really, it's being smart about things.

Regarding paying up front for services, I see nothing wrong at all with that approach. I've been doing that for my prescriptions for years now. If I want the prescriptions, just like any other products, you pay for them on the spot. If someone doesn't have the money in their pocket or checking account, they can elect to charge it on their credit card and pay it back when they can better afford it in the manner they choose. It's called taking responsibility for yourself.

Let's take a health issue that traditionally not covered by insurance, or at least not covered very well, like dental work. For me, the costs for that kind of work is 100% mine. So when I suddenly need a dental implant, I'm looking at spending around $5000. To start, I have to pay the periodontist almost half of that to begin the process, and once the implant is ready for the crown, I also pay the dentist up front to get started.

NW30, sooner or later you need to stand behind your beliefs and embrace the Republican styled healthcare plan that the ACA is. If you don't want health insurance, just pay the fine. Like it or not, we all have to take some responsibility for the poor folks that need health care.

[boggsman1]

[summertime]

I hate to keep sounding like a republican- but in regards to the arguments about the poor paying not getting health care ("do you think health care is only for the middle and upper class?"...) and comments about everyone paying deductibles- the reality is that the poor do get free health care - they qualify for medicaid. When they end up in hospitals without it (thru ER) - social workers guide them through signing up for it. And when low income people with high deductible insurance end up the hospital- they get their deductible waived. I've seen it- I've even heard social workers say to a pt.- "you may or may not be asked to verify your income but if you do you just need your most recent pay stub". (no research into savings, investiments, etc.) Really, the only people that really struggle to pay for insurance are the middle class who have something to lose. Not that I'd want to be poor with nothing to lose. So as for the poor paying deductibles in Obamacare plans- we'll see but I doubt it.

[coboardhead]

Summertime

We do supply health care for the really poor. My question was directed at NW30 to try and get a clear understanding of what he thinks society should provide in the way of health care.

What we have not been doing is providing affordable health insurance and security for the working poor. Those folks that earn above the poverty level, but have jobs that do not pay well enough to afford the $5 k premiums even a high deductible plan carries.

If one has a pre-existing condition and is unemployed, through no fault of his own, the current system will not even allow him to obtain affordable insurance; and his financial security is jeopardized even if he, or his employer, contributed hundreds of thousands in premiums through the years.

You are correct that high deductibles get waived at the hospital for emergent care. The hospital then has the opportunity to bill the insurance company at, what could be, a very high rate that includes factoring in the write off part of the bill. Mission accomplished...cost shifted.

The deductibles do not get waived at the primary care doctor office. It is not feasible to do this for a small practice. So, this is where the responsibility of the patient comes in...routine medical care.

[summertime]

corrections: I have to correct my yest. statement that Kaiser isn't offering HSA qualified plans in the new O care plans- I was erroneously told that that by a Kaiser member services telehone staffer about a month ago. That is wrong- there are 3 HSA qualified plans. Also-the cigna health salesperson was wrong that cigna will guarantee 2013 prices through 2014- now he says he was in error- that was only for Texas. And CA prices won't be out until Nov. 1. This shows how hard it is to get accurate info. Even the very people whose job it is to inform are misinformed. Not that anyone cares about these issues- I just don't want to put false info out there.

[nw30]