American healthcare system

[[be...]]

FG, you could have applied for a hardship exemption from having to get the Obamacare if you didn't make that much money this year, then you wouldn't have to pay a penalty at tax time.

 

Ditto that.

[[Fl...]]

FG, you could have applied for a hardship exemption from having to get the Obamacare if you didn't make that much money this year, then you wouldn't have to pay a penalty at tax time.

 

From what I understand the hardship thing is more than just not having the money to pay it, there are certain criteria you have to meet, like being homeless or filing for bankruptcy. And it only applies to the hardship period, the month before and the month after.

 

Although I might have qualified under some rule, in my case it makes sense for me to go ahead and get the insurance, so that's what I did. My point was that this is basically forced insurance, and that not only negatively affects rich people but it can also affect poor people as well.

[[Ph...]]

US system is about MONEY ONLY.  If they can't make money off you, then you are ignored (at best) or medicated to the gills.

 

Former RN here; I hated that my job was primarily about getting payment codes correct, and making sure all possible supplies/labs were billed for.

 

Patient care is waaaay down at the bottom of concerns.

 

At this point, I believe in *emergency medicine* only.  The origins of physical problems are rarely diagnosed…and pill pushing to mask symptoms dominant.

<<"The origins of physical problems are rarely diagnosed…and pill pushing to mask symptoms dominant.

"

This has been my experience as seen from the patient side.  Fifteen minutes with a hurried doctor and a prescription.  The doctor hands out a prescription so he/she and the patient can believe that some "doctoring" has taken place.  It's a ruse, a sham.  Once we become informed, we can go into a doctor's office and CLEARLY SEE this process for what it is.

[[Ph...]]

@ floriday guy

 

 

That depends on your morals I guess. I don't mind giving to less fortunate people.

 

As do many others. But I don't understand how anyone could believe that it is "moral" to use force to take from one person to give to another, which is what the inefficient and often incompetent government does. 

 

I also don't believe that people don't work out of laziness or on purpose. Because in my opinion people want to be usefull. NObody wants to sit at home and be in bed all day.

 

Nobody wants to sit at home all day? There are plenty of people who would love nothing more than to do just that. And the sad thing is that a welfare state encourages that and serves to keep people dependent, some of whom would excel if they were given the opportunity to do so.

 

Crime is a real problem in much of the world. I live in a relatively safe area, but I still can't leave a bunch of tools in my truck or someone would steal them. If these people wanted to feel "useful" they would go buy their own tools, but its easier for them to take mine than it is to work for their own so some people choose to do that. It's no different with welfare. For every person who could legitimately benefit from it and use it as a stepping stone to help them get their life back on track there are many more who use it as a way to get free stuff.

 

A societal structure that goes against human nature is unsustainable. In practice it seems like a noble idea to make everyone "equal" but the reality is that not everyone has good intentions and a willingness to contribute so eventually these countries will reach a tipping point where the money runs out and the whole thing collapses. Just ask the USSR, Greece and Venezuela how it worked out for them.

Standing applause for Florida Guy.  Bulls eye! 

[[Be...]]

FG, you could have applied for a hardship exemption from having to get the Obamacare if you didn't make that much money this year, then you wouldn't have to pay a penalty at tax time.

 

From what I understand the hardship thing is more than just not having the money to pay it, there are certain criteria you have to meet, like being homeless or filing for bankruptcy. And it only applies to the hardship period, the month before and the month after.

 

Although I might have qualified under some rule, in my case it makes sense for me to go ahead and get the insurance, so that's what I did. My point was that this is basically forced insurance, and that not only negatively affects rich people but it can also affect poor people as well.

 

FG, There's a good chance you would have been approved for an exemption.  I was approved for a hardship exemption a few years ago when Obamacare first came out even though I didn't need it and didn't know at the time.  I already have minimal essential coverage with my Medicare Part A.  It applies for the year, not months before or after.  I was exempt based only on my low disability income.  There are many different types of exemptions. 

[[Fl...]]

Hardship exemptions usually cover the month before the hardship, the months of the hardship, and the month after the hardship.

But in some cases the Marketplace may provide the exemption for additional months, including up to a full calendar year.

 

- For people ineligible for Medicaid only because a state hasn’t expanded Medicaid coverage, the hardship exemption will be granted for the whole calendar year.

- For people eligible for Indian Health Services, the hardship exemption lasts as long as you remain eligible.

- For people under 21 who are eligible for an exemption due to religious conscience, you’ll need to reapply if you remain a member when you turn 21.

 

https://www.healthcare.gov/health-coverage-exemptions/hardship-exemptions/

 

It doesn't matter for me though, $38 per month healthcare insurance is a no brainer for me so an exemption is a moot point.

[[Be...]]

FG, what is your yearly deductible and co-pays?  What does it cover?  That's good you got a lower premium. 

[[Be...]]

Hardship exemptions usually cover the month before the hardship, the months of the hardship, and the month after the hardship.

But in some cases the Marketplace may provide the exemption for additional months, including up to a full calendar year.

 

- For people ineligible for Medicaid only because a state hasn’t expanded Medicaid coverage, the hardship exemption will be granted for the whole calendar year.

- For people eligible for Indian Health Services, the hardship exemption lasts as long as you remain eligible.

- For people under 21 who are eligible for an exemption due to religious conscience, you’ll need to reapply if you remain a member when you turn 21.

 

https://www.healthcare.gov/health-coverage-exemptions/hardship-exemptions/

 

It doesn't matter for me though, $38 per month healthcare insurance is a no brainer for me so an exemption is a moot point.

 

I guess if your hardship is ongoing, it will cover the year.  My premiums were quoted at about $90/month with a very high deductible.  I'm a smoker.  They quadruple smokers' premiums right off the bat. 

[[Fl...]]

FG, what is your yearly deductible and co-pays?  What does it cover?  That's good you got a lower premium.

 

$0 Deductible, $950 out of pocket limit, no limit on what the plan pays, primary care office visits $0, 4+ visits $1ea, specialist copay $3, diagnostics $4, generic drugs $0-$10, ER visit $100, urgent care $25, transportation 25% copay....those are some of the main points.

 

This is actually good insurance. Obama (taxpayers) are paying $341 of the $378 payment. Obviously it works out to my favor now, I don't agree with it but that's the way it is so I might as well enjoy it while it lasts 

[[Be...]]

FG, what is your yearly deductible and co-pays?  What does it cover?  That's good you got a lower premium.

 

$0 Deductible, $950 out of pocket limit, no limit on what the plan pays, primary care office visits $0, 4+ visits $1ea, specialist copay $3, diagnostics $4, generic drugs $0-$10, ER visit $100, urgent care $25, transportation 25% copay....those are some of the main points.

 

This is actually good insurance. Obama (taxpayers) are paying $341 of the $378 payment. Obviously it works out to my favor now, I don't agree with it but that's the way it is so I might as well enjoy it while it lasts 

 

That's good coverage.  Are you planning on getting any tests done to check out what the benzo beast has done to us? 

[[Fl...]]

That's good coverage.  Are you planning on getting any tests done to check out what the benzo beast has done to us?

 

I don't know what good it would do. I suppose I could get vitamin levels checked, and maybe testosterone just to see where I am at. I just know there is a drug for just about everything and the last thing I want to do is have to get into a discussion with the doctor about why I will only take certain things.

 

One thing I might get checked for is sleep apnea. The past few nights I have slept very well but I have had some really rough sleep off and on recently that I think could be related to sleep apnea. Who knows. Honestly though, if that is a problem I could very likely solve it by losing a few pounds so it might pay me to buckle down and make that happen first.

[[Be...]]

That's good coverage.  Are you planning on getting any tests done to check out what the benzo beast has done to us?

 

I don't know what good it would do. I suppose I could get vitamin levels checked, and maybe testosterone just to see where I am at. I just know there is a drug for just about everything and the last thing I want to do is have to get into a discussion with the doctor about why I will only take certain things.

 

One thing I might get checked for is sleep apnea. The past few nights I have slept very well but I have had some really rough sleep off and on recently that I think could be related to sleep apnea. Who knows. Honestly though, if that is a problem I could very likely solve it by losing a few pounds so it might pay me to buckle down and make that happen first.

 

I always think about Hope4Us's latests posts.  The docs ran so many tests on her and finally found some positives.  Abnormal SPECT brain scan and many autoantibodies wreaking havoc with her brain and CNS.  High voltage gated calcium channel antibodies attacking her brain, she posts.  Benzo site of action?  Here's her posts if you haven't read them.  Antibodies are the culprit for her.  The book "Brain on Fire" where the lady had brain encephalitis. 

 

 

http://www.benzobuddies.org/forum/index.php?topic=27174.msg2102564#msg2102564

 

If I had the money and the means, I'd get a fMRI or SPECT scan and more antibody tests done.  There's a fire in my brain, for sure.  I wish to God I knew what was really going on with me and it could be documented, so my family and friends would stop seeing me as a kook. 

[[Ch...]]

Where do you live again, FG?

 

With your *parents*?  What happens to all those PAWS sufferers who never even know what is wrong with them because they can't afford an internet connection and discover BB or some other website that clues them in?  Or get fired from their jobs for cognitive issues?  Or kicked out of their homes and have NOWHERE to go cuz they weren't born into the 'right' family?  Sounds like you ascribe to the 'only the strong survive' school of life.

 

We are all one.  From each according to their ability, to each according to their need.  If *I* have enough, how does it harm me to share my excess with someone less endowed?

 

I'm sure it doesn't harm you and I encourage you to be as charitable as you are willing and able to be. I encourage that of everyone. Private charity is a great thing and that is how these problems should be addressed.

 

The issue I have is with government forcibly taking from one person and giving to the next. I can't even imagine how anyone could consider that to be "fair".

 

Do you take issue with other programs or is it just social assistance that gets your dander up?

 

I don't have children but my tax dollars go towards building schools and providing an education for other people's children.

 

Is that fair? Probably not, but I don't have a problem with it.

 

 

 

 

 

 

 

[[bu...]]

 

 

Do you take issue with other programs or is it just social assistance that gets your dander up?

 

I don't have children but my tax dollars go towards building schools and providing an education for other people's children.

 

Is that fair? Probably not, but I don't have a problem with it.

 

An educated populace is benefit to society as a whole.  The benefits of public education go far beyond the specific benefit to the children.

[[Ch...]]

 

 

Do you take issue with other programs or is it just social assistance that gets your dander up?

 

I don't have children but my tax dollars go towards building schools and providing an education for other people's children.

 

Is that fair? Probably not, but I don't have a problem with it.

 

An educated populace is benefit to society as a whole.  The benefits of public education go far beyond the specific benefit to the children.

 

Yeah, I get that Builder, it was just an example. 

 

 

 

 

 

 

 

 

 

 

 

 

 

[[li...]]

FG,

 

That insurance seems fantasic. I'm paying a lot more for a lot less.

 

You don't need a referral ?

[Guest [mu...]]

FG, what is your yearly deductible and co-pays?  What does it cover?  That's good you got a lower premium.

 

$0 Deductible, $950 out of pocket limit, no limit on what the plan pays, primary care office visits $0, 4+ visits $1ea, specialist copay $3, diagnostics $4, generic drugs $0-$10, ER visit $100, urgent care $25, transportation 25% copay....those are some of the main points.

 

This is actually good insurance. Obama (taxpayers) are paying $341 of the $378 payment. Obviously it works out to my favor now, I don't agree with it but that's the way it is so I might as well enjoy it while it lasts 

 

That is crazy good insurance! My husband and I bought the cheapest plan available to us and the monthly premium is $447. Our deductible is $3,000 (each), with a maximum out-of-pocket of $7,150 per person. Our co-pay for an emergency room service is $500. NOTHING out of network is covered or counts towards out-of-pocket totals, and you only get one preventative exam covered per year. You also need to call the insurance company before each doctor visit or it's not covered (I found that out the hard way). They give you a break if you're incapacitated in the emergency room, but only if you can prove it later. And good luck if you ever need to call about something simple like an address change, because the insurance company is different from the billing company, and you'll get passed back and forth for months. And every single year they erroneously claim that you didn't pay all your bills and thus will be penalized by the government, and then you have to go through the hassle of proving that you did pay them.

 

Last year's coverage was still terrible but better than this. Services get downgraded every year, yet the costs keep going up. So basically, it's too expensive to use, and yet we're forced to buy it anyway.

 

There is nothing progressive about Obamacare. Forcing those with low and middle class incomes to pay for poor-quality insurance (that they then can't afford to use) so that even poorer people can get high quality insurance for next to nothing is ridiculous, and merely shifts the problem without solving anything.

 

[[fi...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

That statement might be true, but a link or other attribution would certainly increase its credibility.

 

GREAT reply builder - you're wording was very kind - and I agree bc I like seeing the stats in print that support our opinions or knowledge

 

I think healthcare in the US SUX unless you need a heart transplant or you have cancer - but when a hammer, everything looks like a nail and the Dr's here in the US have zero knowledge of Benzodiazepine Withdrawal Syndrome - zero - (for the most part) There is no wizard behind that curtain - this is just my own opinion.....today.

[[Fl...]]

Do you take issue with other programs or is it just social assistance that gets your dander up?

 

The less government interference, the better. Obviously we need some government but the idea that the solution to all of these problems is to keep applying more and more pressure to the people who produce things to relieve the pressure for the people who don't (for legitimate reasons or otherwise) is a recipe for disaster. Not everyone wants "free stuff", but plenty of people do and the motivation will always move when the incentive shifts. If everyone was on the up and up these programs wouldn't be an issue, but all it takes is a few bad apples to spoil the bunch and unfortunately there are more than a few out there.

 

I don't have children but my tax dollars go towards building schools and providing an education for other people's children.

 

Is that fair? Probably not, but I don't have a problem with it.

 

It is great that you don't mind funding things that benefit other people, but why should everyone be forced to do this? I suppose as builder mentioned the argument could be made that the benefits to me outweigh the costs, but it is easy to fall into the trap of believing that the whole world will crumble if people are left to decide things for themselves when the reality is that this freedom is what built this country. People can't see it now because everything is buried in red tape so when a system fails it's easy to blame the free market, when in reality it is the lack of a truly free market that caused the majority of the issues.

 

In other words, you should be free to support the education of other people's children as you see fit. But why should I have to? One of the reasons why I have made a conscious choice not to have children is because it costs a lot of money. If I choose to have zero children to keep my costs down, how is it fair for me to have to help someone else who chooses to have many children? ESPECIALLY if having those children means that I will also be having to pay for their food, housing and healthcare with more of my tax dollars.

 

The bottom line is that we should be free to choose who we help and who we don't help. Letting government take it from some and give to others is not the answer. Let people keep their money and make their own decisions about where it should go. Having localized control keeps the "assistance" out of the hands of dishonest people. It also makes people think twice before making poor and selfish decisions when they know that the only help available is through local organizations who have better control over who truly deserves assistance.

 

FG,

 

That insurance seems fantasic. I'm paying a lot more for a lot less.

 

You don't need a referral ?

 

Yes, I believe I do need a referral to see a specialist.

 

There is nothing progressive about Obamacare. Forcing those with low and middle class incomes to pay for poor-quality insurance (that they then can't afford to use) so that even poorer people can get high quality insurance for next to nothing is ridiculous, and merely shifts the problem without solving anything.

 

I agree. Lets hope that we see some positive changes with this new administration.

 

I think healthcare in the US SUX unless you need a heart transplant or you have cancer - but when a hammer, everything looks like a nail and the Dr's here in the US have zero knowledge of Benzodiazepine Withdrawal Syndrome - zero - (for the most part) There is no wizard behind that curtain - this is just my own opinion.....today.

 

I wouldn't say that it sucks, but it is definitely flawed. I think the further you get away from critical care and the closer you get to "comfort" care the more these flaws become evident.

[[Te...]]

I don't have any confidence in the new administration's treatment of health care. I'm glad I'll be going to Medicare, but there's talk about privatizing it. It all speaks of more money for corporations.

[[wa...]]

It is often that we condemn something while at the same time embracing/participating in it.  I understand, though. 

 

In the new administration - maybe people will be left to decide for themselves and their children not to get insurance  - thinking it is no different than any other purchase.  When things go wrong shall they be turned away from the hosp or doc?  Who pays then if they don't have the finances? -- probably those already paying for health insurance or out of pocket. 

Hosps can only write off so much.  Charity from the hugely wealthy?  interesting.  Then what will the powerful monied folks want?  Are they so benevolent?

 

I see no point anymore to this merrygoround discussion.  I've seen it a thousand times from "purist" conservatives.  It never goes anywhere and no one is ever convinced by the other.    It is a good distraction though but I think I'll step off here.  WBB

[[li...]]

FG,

 

'Yes, I believe I do need a referral to see a specialist.' But is it given easily, or is the GP trying to restrict access , as well as access to non-controlled drugs ?

 

You may want to learn before you sign up. What I have now (mandatory) is junk.

[[bu...]]

  Who pays then if they don't have the finances? -- probably those already paying for health insurance or out of pocket. 

. 

 

Of course.  Those uncompensated services just become part of the operating overhead, and are added to fees paid by insurance programs and private pay patients.

[[Be...]]

FG, depending on your income, $40/mo. for premium pay seems high to me.  I know I couldn't afford it on my disability.  I hope your premiums and other costs don't go up next year?  I guess you won't be able to cancel it then? 

[[Fl...]]

I don't have any confidence in the new administration's treatment of health care.

 

Time will tell but as it stands I don't know one person who is happy with obamacare or the system in general. Not a single one.

 

I'm glad I'll be going to Medicare, but there's talk about privatizing it. It all speaks of more money for corporations.

 

As opposed to the money going to inefficient government administration and bureaucracy. Competition breeds efficiency and that in turn should result in lower costs for the consumer. Just about anything the government can do, a truly free market can do much better.

 

FG,

 

'Yes, I believe I do need a referral to see a specialist.' But is it given easily, or is the GP trying to restrict access , as well as access to non-controlled drugs ?

 

I honestly don't know but I am not too concerned. I have always been pretty healthy outside of this current mess that I am in and I don't see myself needing much in the way of specialists outside of unforseen circumstances, plus I have never had a problem in the past getting referrals.

 

Not sure what you mean by access to non-controlled drugs.

 

FG, depending on your income, $40/mo. for premium pay seems high to me.  I know I couldn't afford it on my disability.  I hope your premiums and other costs don't go up next year?  I guess you won't be able to cancel it then? 

 

High? That isn't high at all, especially considering this is good coverage.

 

I could have gotten a free plan but it didn't look like it would be of any use at all. As it stands now I pay $60 every few months just to get my BP med script refilled, so the way I see it I will only be paying $23 per month more than I already pay for the maintenance care and I will truly be covered if anything does happen. I wouldn't pay $400 per month for that but I will gladly pay $23.