Traveler Posted November 22, 2017 Report Share Posted November 22, 2017 I little over a year ago I was diagnosed with a macular hole (eye - if anyone is wondering). This is likely a genetic defect that manifests itself with aging. I have a grandparent that went blind – likely this was the cause and 4 siblings with similar problems. As a follow-on, after all the surgery for the macular hole I have developed a cataract and will require additional eye surgery. With the upcoming surgery, I have been reviewing the copayments that have become what I consider excessive so I have been doing some complaining and demanding information. I was contacted today and informed that I can proceed with the same doctor I was seeing and instead of charging the procedure to my insurance I could opt to pay for everything myself out of pocket. This did not seem like much of an option until I discovered that the total cost to me would be less than my copay charging the procedure to insurance. I am so glad that the government has become involved with health insurance. (please understand the last statement is sarcasm) The Traveler JohnsonJones and zil 2 Quote Link to comment Share on other sites More sharing options...
prisonchaplain Posted November 22, 2017 Report Share Posted November 22, 2017 (edited) I remember paying an oral surgeon $1,100 to extract 7 teeth (4 impacted). The price included general anesthesia. I told the finance folks that I could pay with 4 post-dated checks, spaced one month apart each, if that would work. They assured me it was no problem, and said that they would get my money much quicker than they would have if I had used insurance. This was right around 1990, but I doubt much has changed. Edited November 22, 2017 by prisonchaplain Quote Link to comment Share on other sites More sharing options...
JohnsonJones Posted November 23, 2017 Report Share Posted November 23, 2017 6 hours ago, Traveler said: I little over a year ago I was diagnosed with a macular hole (eye - if anyone is wondering). This is likely a genetic defect that manifests itself with aging. I have a grandparent that went blind – likely this was the cause and 4 siblings with similar problems. As a follow-on, after all the surgery for the macular hole I have developed a cataract and will require additional eye surgery. With the upcoming surgery, I have been reviewing the copayments that have become what I consider excessive so I have been doing some complaining and demanding information. I was contacted today and informed that I can proceed with the same doctor I was seeing and instead of charging the procedure to my insurance I could opt to pay for everything myself out of pocket. This did not seem like much of an option until I discovered that the total cost to me would be less than my copay charging the procedure to insurance. I am so glad that the government has become involved with health insurance. (please understand the last statement is sarcasm) The Traveler While I haven't had this exact phenomenon (perhaps because I've never investigated how much it would cost for self-pay), my premiums have shot up just as much if not more every year under the ACA as they did prior. Furthermore, due to some things in the ACA, my benefits have decreased tremendously (gone from 100% everything covered, to only 80% coverage with a co-pay and deductible, as well as only 50% of dental operations covered). The ACA has done nothing but hurt the middle class from my perspective...makes me grumble as well. Then the do nothing Republican Congress that vowed to repeal it or replace it with something better is more interested in tax cuts for the wealthy rather than either reducing the deficit (which I thought was something over 50% of them ran on), or doing more permanent cuts for the middle class (or in my instance, tax cuts that aren't cuts, but actually look like they will raise my taxes...I'm in that lucky group of Middle Class individuals...wonderful stuff eh...and it get's better with the Tithing no longer counting as a deduction, or other deductions that we could take in the past). Despite what they said (the Republicans) I don't think they are interested anymore than Democrats at changing this up. At least they are talking about getting rid of the tax just for being alive in their tax overhaul...but I expect that if they do that but leave the rest of the ACA in place we'll see a meteoritic rise of premiums without much of a return...and perhaps an even larger rise of our deductible while we have a reduction of benefits. I'd like it if real work was done on insurance and health overhaul, I don't have any faith in either party that they will actually do anything to make it better at this point. I have even greater doubts after recent events of the past year that they'll even repeal the entirety of it and let capitalism actually handle the markets (which may reduce premiums and bring back the old policies that I used to have). Quote Link to comment Share on other sites More sharing options...
Guest Posted November 27, 2017 Report Share Posted November 27, 2017 My sister and I just had a long discussion about her medical conditions. I would think that she would be exactly the kind of person that Obamacare is supposed to help. She has almost no income. She has a chronic, very painful, and very expensive condition. Her description of what happened in the past few years seems like torture. She was having regular treatments for a few years prior to Obamacare. It was all paid for by insurance. Since Obamacare, each year premiums went higher and higher. Deductibles likewise. She is now unable to pay for the premiums. And the deductibles are too high for her income. And to add insult to injury, SSI disability has been denied her twice since they don't believe her condition despite documented proof. So, she has to take the Federal Government to court to receive disability sufficient to pay for her medical procedures. So, yeah... who said Obamacare is good for poor people? Quote Link to comment Share on other sites More sharing options...
zil Posted November 27, 2017 Report Share Posted November 27, 2017 52 minutes ago, Carborendum said: So, yeah... who said Obamacare is good for poor people? No one I know in real life is benefiting from this supposed benefit. Everyone I know in real life has the same issues as your sister - higher premiums, higher deductibles, reduced benefits. Obama would have been just as useful, and a lot faster, if he'd just sent the military out to shoot half of us. Quote Link to comment Share on other sites More sharing options...
askandanswer Posted November 27, 2017 Report Share Posted November 27, 2017 This is very topics in the Australian context. It was only just yesterday that Morgan Stanley, a major investment bank, release a report claiming that the public health system is now so good that people don't actually need private insurance. Here is how one newspaper reported on the report: https://www.dailytelegraph.com.au/business/is-the-public-health-system-so-good-you-dont-actually-need-private-insurance/news-story/ee299dd52aac8e1b948effa3fd4c9e58 SAVE your money and don’t bother with private health insurance. The public hospital system is now so good Australians can get away with not joining a health fund, a major investment bank has found. And the claim private health insurance is vital to easing pressure on public hospital waiting lists is also a myth according to investment adviser Morgan Stanley. In a 63-page analysis obtained by News Corp the investment bank warns “many people now see the free public hospital system as adequate catastrophe cover”. Quote Link to comment Share on other sites More sharing options...
Alex Posted November 27, 2017 Report Share Posted November 27, 2017 (edited) 1 hour ago, askandanswer said: This is very topics in the Australian context. It was only just yesterday that Morgan Stanley, a major investment bank, release a report claiming that the public health system is now so good that people don't actually need private insurance. Here is how one newspaper reported on the report: https://www.dailytelegraph.com.au/business/is-the-public-health-system-so-good-you-dont-actually-need-private-insurance/news-story/ee299dd52aac8e1b948effa3fd4c9e58 SAVE your money and don’t bother with private health insurance. The public hospital system is now so good Australians can get away with not joining a health fund, a major investment bank has found. And the claim private health insurance is vital to easing pressure on public hospital waiting lists is also a myth according to investment adviser Morgan Stanley. In a 63-page analysis obtained by News Corp the investment bank warns “many people now see the free public hospital system as adequate catastrophe cover”. Yeah, I saw this report as well- the private health insurance industry is stunned and they'll no doubt find a way to torpedo the findings. I think the best thing about the health system in Aus is that Australia has torn down all those awful old hospitals built prior to the 1950's so hospitals aren't nearly as depressing as they were. The shared wards are not nearly as crowded as they were in the 1980's even. However in the UK they still have ghastly old hospitals that resemble morgues- it's as if they were afraid of windows/light when they were designed. Oh, and this is an excellent assessment of why the cost of healthcare in the USA is skyrocketing. Neither socialist nor capitalist leaning explanation btw as it focuses on the numbers: https://www.youtube.com/watch?v=QXdQPsQRE7I Edited November 27, 2017 by Alex Quote Link to comment Share on other sites More sharing options...
askandanswer Posted November 27, 2017 Report Share Posted November 27, 2017 I'm really pleased by the fact that after years and years of paying a fortune in premiums, the last three years we have finally been getting back more than we paid. Quote Link to comment Share on other sites More sharing options...
Sunday21 Posted November 28, 2017 Report Share Posted November 28, 2017 (edited) We don’t have shared wards anymore but..we have a notorious hospital emergency in town. One of my students went there with dizziness at 1 am. His blood pressure was low. by 7 am the next morning they had not yet seen him. They were pretty rude to him too. Sigh ? Edited November 28, 2017 by Sunday21 Quote Link to comment Share on other sites More sharing options...
anatess2 Posted November 28, 2017 Report Share Posted November 28, 2017 Well, Obamacare is not "insurance" so... Quote Link to comment Share on other sites More sharing options...
Anddenex Posted December 4, 2017 Report Share Posted December 4, 2017 I am going to say it really depends on your health insurance options. Having had multiple different providers, and also having no insurance, the current plan I am on with my company can't be beat. It is one good thing from my job. My parents have a friend who needed heart surgery. They didn't have insurance. Cost of procedure was $90K with insurance. Cost of procedure without insurance $50K. Our vision is really good. With an old insurance I paid $300 out of pocket for one child. With my new insurance I paid $120 out of pocket for 4 children and 1 adult. So, my experience, if you can and have the funds would be avoid insurance as some places offer cash discount if you can pay cash. If not, depending on where you work, health insurance can be a real benefit. Don't care much for Obamacare, haven't seen anything good from it and all that I have heard hasn't been good. Quote Link to comment Share on other sites More sharing options...
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