Gruber gets grilled tomorrow

[compuwiz1]

http://aspe.hhs.gov/daltcp/reports/liens.htm



"Highlights of the 1993 Estate Recovery Mandate:

States must pursue recovering costs for medical assistance consisting of:
•Nursing home or other long-term institutional services;
•Home- and community-based services;
•Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and
•At State option, any other items covered by the Medicaid State Plan.
•At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient"

 

[werepossum]

I wonder how much of this low rate increase is being driven by people forced into worse insurance plans? My insurance rates went down a tiny bit, but had we kept the same insurance plan (now made ACA-compliant) they'd have jumped almost thirty percent. Instead we now have insurance which pays for much less and pays providers much less. Consequently it's not accepted by all area doctors, and every doctor I have has signs posted that they do not accept it for new patients. I'm also wondering about blood work; my last thyroid cancer doctor checkup he sent me to the Memorial Hospital lab to have blood drawn rather than doing it in-house. A friend's bi-yearly blood work went from $120 to $600, so I'm really hoping I don't get hit like that.

 

[OverVolt]

I wonder how much of this low rate increase is being driven by people forced into worse insurance plans? My insurance rates went down a tiny bit, but had we kept the same insurance plan (now made ACA-compliant) they'd have jumped almost thirty percent. Instead we now have insurance which pays for much less and pays providers much less. Consequently it's not accepted by all area doctors, and every doctor I have has signs posted that they do not accept it for new patients. I'm also wondering about blood work; my last thyroid cancer doctor checkup he sent me to the Memorial Hospital lab to have blood drawn rather than doing it in-house. A friend's bi-yearly blood work went from $120 to $600, so I'm really hoping I don't get hit like that.

No you saved money CNN says so I read it yesterday.

 

[werepossum]

http://aspe.hhs.gov/daltcp/reports/liens.htm



"Highlights of the 1993 Estate Recovery Mandate:

States must pursue recovering costs for medical assistance consisting of:
•Nursing home or other long-term institutional services;
•Home- and community-based services;
•Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and
•At State option, any other items covered by the Medicaid State Plan.
•At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient"

That happened to my cousin. He had a convenience store/restaurant with his father-in-law who was retired and on Medicare/Medicaid. Father-in-law got cancer, needed a lot of expensive treatment, and died. Medicare/Medicaid then seized the store; since it was a joint partnership rather than an LLC, they could take the entire store instead of just his share of stock. This was years before Obama became President.

 

[OverVolt]

That happened to my cousin. He had a convenience store/restaurant with his father-in-law who was retired and on Medicare/Medicaid. Father-in-law got cancer, needed a lot of expensive treatment, and died. Medicare/Medicaid then seized the store; since it was a joint partnership rather than an LLC, they could take the entire store instead of just his share of stock. This was years before Obama became President.

Mmmhmmm some people just don't even bother to read what they are signing these days. I don't know why anyone would even try and argue to the contrary on medicaid coming after assets. Everybody should be informed about what they are getting into.

 

[werepossum]

No you saved money CNN says so I read it yesterday.

The sucky thing is that one refill of our Synthroid costs us more than we saved a year by going to the cheapo insurance. Every month or so we discover yet another way this new insurance sucks. Obama's lies aside, I accept that I'll have to pay more to fund the newly insured, but I do wish we weren't getting screwed every time we turn around.

 

[compuwiz1]

That happened to my cousin. He had a convenience store/restaurant with his father-in-law who was retired and on Medicare/Medicaid. Father-in-law got cancer, needed a lot of expensive treatment, and died. Medicare/Medicaid then seized the store; since it was a joint partnership rather than an LLC, they could take the entire store instead of just his share of stock. This was years before Obama became President.

I believe this. My point is that people need to understand what they are getting into with the ACA, Obamacare, whatever. If you get shifted to Medicaid that will be the fate of your estate. You're right, I believe they have always had this right of recovery. Younger people might become victim to this "unintended consequence" of signing up.

 

[werepossum]

Odd. You used to declare the ACA a certain failure. Now it's "let's wait and see?"

:hmm:

Anyway, it's apparent that more and more people are actually paying attention to real numbers, rather than just regurgitate lie-bassd talking points.

Such as:
If you like your plan, you can keep it.
If you like your doctor, you can keep him.
My plan will save the average family $2,500 a year.

 

[werepossum]

I believe this. My point is that people need to understand what they are getting into with the ACA, Obamacare, whatever. If you get shifted to Medicaid that will be the fate of your estate. You're right, I believe they have always had this right of recovery. Younger people might become victim to this "unintended consequence" of signing up.

Lot of that going around. My ex-neighbor was waaay behind on house payments, basically just stopped making them. Her bank tried to get her to refinance with the new Obama plan to get back on track, but her sister-in-law pointed out that under the new plan, the federal government guarantees the loan to convince the banks to refi. If you owe $180K and your house is now worth $150, the bank loses $30k plus expenses if it pops your house. Under the new plan, Uncle Sugar picks up the $30k plus whatever expenses the bank can make look good.

 

[fskimospy]

I wonder how much of this low rate increase is being driven by people forced into worse insurance plans? My insurance rates went down a tiny bit, but had we kept the same insurance plan (now made ACA-compliant) they'd have jumped almost thirty percent. Instead we now have insurance which pays for much less and pays providers much less. Consequently it's not accepted by all area doctors, and every doctor I have has signs posted that they do not accept it for new patients. I'm also wondering about blood work; my last thyroid cancer doctor checkup he sent me to the Memorial Hospital lab to have blood drawn rather than doing it in-house. A friend's bi-yearly blood work went from $120 to $600, so I'm really hoping I don't get hit like that.

Remember, overall health care spending inflation is also very low. That should answer your question.

 

[Jhhnn]

http://aspe.hhs.gov/daltcp/reports/liens.htm



"Highlights of the 1993 Estate Recovery Mandate:

States must pursue recovering costs for medical assistance consisting of:
•Nursing home or other long-term institutional services;
•Home- and community-based services;
•Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and
•At State option, any other items covered by the Medicaid State Plan.
•At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient"

http://www.factcheck.org/2014/01/medicaid-estate-recovery-program/

 

[Jhhnn]

Lot of that going around. My ex-neighbor was waaay behind on house payments, basically just stopped making them. Her bank tried to get her to refinance with the new Obama plan to get back on track, but her sister-in-law pointed out that under the new plan, the federal government guarantees the loan to convince the banks to refi. If you owe $180K and your house is now worth $150, the bank loses $30k plus expenses if it pops your house. Under the new plan, Uncle Sugar picks up the $30k plus whatever expenses the bank can make look good.

Which was a problem for your ex-neighbor in what way, exactly? The refi includes all missed payments & penalties at a lower interest rate, providing a fresh start. There's no catching up- she just has to make the new payments.

And how does that affect a servicer's decision to foreclose on a note held by a REIT that they administer? The bank itself suffers no loss in either scenario.

 

[Jhhnn]

I believe this. My point is that people need to understand what they are getting into with the ACA, Obamacare, whatever. If you get shifted to Medicaid that will be the fate of your estate. You're right, I believe they have always had this right of recovery. Younger people might become victim to this "unintended consequence" of signing up.

Recovery only applies to unmarried people 55 & older who receive extended care, as in a nursing home.

 

[Jhhnn]

The sucky thing is that one refill of our Synthroid costs us more than we saved a year by going to the cheapo insurance. Every month or so we discover yet another way this new insurance sucks. Obama's lies aside, I accept that I'll have to pay more to fund the newly insured, but I do wish we weren't getting screwed every time we turn around.

A 90 day supply is ~$100.

http://www.goodrx.com/synthroid?gclid=CI7C24WbyMICFQwEaQodUksAdg

You found a cheapo insurance plan that saves you $8/mo? On the exchange? Or through your employer?

Or just propagandizing as usual?

 

[Zorkorist]

Would you look at that..... Not I the individual, but we the people..... I had no idea I lived in a communist state. I did, however, learn what words imply.

We, the people, Moonbeam. The collective, the plural, "we"...

"the people," the individual, with rights...

This country has always been about individual rights.

Haters can hate, and make a billion arguments for Socialism, but all of those arguments fall on deaf ears.

My ears.

-John

 

[zinfamous]

Such as:
If you like your plan, you can keep it.
If you like your doctor, you can keep him.
My plan will save the average family $2,500 a year.

fair enough.

 

[Victorian Gray]

A 90 day supply is ~$100.

http://www.goodrx.com/synthroid?gclid=CI7C24WbyMICFQwEaQodUksAdg

You found a cheapo insurance plan that saves you $8/mo? On the exchange? Or through your employer?

Or just propagandizing as usual?

Good grief that's expensive. 90 day supply (generic) here costs me $22.75 (Cdn). I keep reading/hearing about how expensive drugs are in the US but this seems ridiculous for a drug that's been around since 1955.

 

[OverVolt]

..

 

[Jhhnn]

Anywho my affordable insurance went from $153 to $210 for much worse coverage. $1500 deductible to $4000. I get to say "thanks Obama" considering its Obamacare

Challenged to substantiate your claims earlier in this very thread, you tripped over your dick & deleted several posts, some which were preserved as quotes.

You want a re-do, like that never happened? Really?

 

[werepossum]

A 90 day supply is ~$100.

http://www.goodrx.com/synthroid?gclid=CI7C24WbyMICFQwEaQodUksAdg

You found a cheapo insurance plan that saves you $8/mo? On the exchange? Or through your employer?

Or just propagandizing as usual?

We could not come close to affording our HSA plan after the required Obamacare changes, so we dropped to a cheaper plan that covers less and pays providers less. After its cost was increased to be Obamacare-compliant, we save less than $2 per month if memory serves, or roughly $20 per year for my wife and I. Each Synthroid prescription costs us roughly $25 more under this new policy IF we use the GoodRX coupons. (Went from high seventies to $120+, and the GoodRX coupon is supposed to knock off $20.)

Something else we're running into is that because of the lower pay-outs, providers are now sending us to hospital labs for blood work and scans as the compensation is less than their cost. I'm looking into paying cash prices out of pocket because at least in some cases the uninsured cash price is considerably lower than the hospital labs' negotiated rates with our new, Obamacare-compliant policy. Downside is that Blue Cross Blue Shield doesn't want to count this as part of our deductible - which Obama thoughtfully increased from $2,700 to $3,700.

Frankly I don't know where we take this. Oldish folks like me would be better if we dropped company insurance and individually went to the federal exchange - assuming SCOTUS doesn't strike down the subsidies and our identities aren't stolen. But we've hired some young drafters and they'd take it in the shorts on the exchanges. Every single one of our employees (except for a couple with good government insurance via spouses - but those are now kicking spouses off if they have insurance offered) is now materially worse off, but there doesn't seem to be any way out without somebody being even worse off than now. Sucks.

 

[werepossum]

Good grief that's expensive. 90 day supply (generic) here costs me $22.75 (Cdn). I keep reading/hearing about how expensive drugs are in the US but this seems ridiculous for a drug that's been around since 1955.

Part of the problem is that generics are legally allowed to range +20% to -20% and with thyroid hormone there's a small range between the therapeutic threshold and the toxic threshold. I can easily get generic levothyroxine for $4/month or $10/ninety days with any insurance or with no insurance at all. Problem is one month I can barely drag myself out of bed and the next I'm suffering muscle cramps and blinding headaches. I could have my dose recalibrated to generic levothyroxine (made from a mixture of bird and bovine thyroid gland extractions rather than synthesized inorganically) easily enough, but the variability prevents that. Besides the 20% variability, the ratio of bird to bovine extractions vary with price and availability, and each individual's sensitivity to each type varies. Also, as a thyroid cancer survivor my levels are kept high to suppress any cancerous thyroid cells that might have migrated before or during surgery, so three months low levels might increase my cancer recurrence risk.

Might be easier on my wife as hers is a low dose supplemental therapy to supplement her thyroid gland's production, but for a hundred bucks a month I'm not exposing my wife to muscle cramps and blinding headaches.

 

[zinfamous]

We could not come close to affording our HSA plan after the required Obamacare changes, so we dropped to a cheaper plan that covers less and pays providers less. After its cost was increased to be Obamacare-compliant, we save less than $2 per month if memory serves, or roughly $20 per year for my wife and I. Each Synthroid prescription costs us roughly $25 more under this new policy IF we use the GoodRX coupons. (Went from high seventies to $120+, and the GoodRX coupon is supposed to knock off $20.)

Something else we're running into is that because of the lower pay-outs, providers are now sending us to hospital labs for blood work and scans as the compensation is less than their cost. I'm looking into paying cash prices out of pocket because at least in some cases the uninsured cash price is considerably lower than the hospital labs' negotiated rates with our new, Obamacare-compliant policy. Downside is that Blue Cross Blue Shield doesn't want to count this as part of our deductible - which Obama thoughtfully increased from $2,700 to $3,700.

Frankly I don't know where we take this. Oldish folks like me would be better if we dropped company insurance and individually went to the federal exchange - assuming SCOTUS doesn't strike down the subsidies and our identities aren't stolen. But we've hired some young drafters and they'd take it in the shorts on the exchanges. Every single one of our employees (except for a couple with good government insurance via spouses - but those are now kicking spouses off if they have insurance offered) is now materially worse off, but there doesn't seem to be any way out without somebody being even worse off than now. Sucks.

The good thing about absurd costs for horribly inefficient yet completely necessary tests such as blood tests are that they are fixed by technology.

Lab testing that you see today, typically in hospital services, really won't be part of the equation 2 years from now.

When considering such expenses, it is important to accept that the current and classic model that insurance companies, their lobbyists, and their pocket congress critters use to scare their customers and their constituents into fear of reform, are grossly ill-suited for what is actually happening, today

http://www.newyorker.com/magazine/2014/12/15/blood-simpler


$100 blood test? lol--try $3. These things are happening, and this is why the ACA is an invaluably important piece of legislation. It doesn't go far enough, obviously, in jettisoning Blue Cross and their cronies, but it is malleable enough to let technology step in and obsolete their model without them even knowing it.

It's similar to the 19th-20th century problem in NYC regarding the predicted problem of the city being covered in 10 feet of horseshit within the next 15 years (exploding population growth, dependance on horses and horse-drawn carriages). Unbeknownst to the top city planners and engineers wracking their brains over this dire yet inevitable situation, the car was about to show up and fix everything.

 

[werepossum]

The good thing about absurd costs for horribly inefficient yet completely necessary tests such as blood tests are that they are fixed by technology.

Lab testing that you see today, typically in hospital services, really won't be part of the equation 2 years from now.

When considering such expenses, it is important to accept that the current and classic model that insurance companies, their lobbyists, and their pocket congress critters use to scare their customers and their constituents into fear of reform, are grossly ill-suited for what is actually happening, today

http://www.newyorker.com/magazine/2014/12/15/blood-simpler


$100 blood test? lol--try $3. These things are happening, and this is why the ACA is an invaluably important piece of legislation. It doesn't go far enough, obviously, in jettisoning Blue Cross and their cronies, but it is malleable enough to let technology step in and obsolete their model without them even knowing it.

It's similar to the 19th-20th century problem in NYC regarding the predicted problem of the city being covered in 10 feet of horseshit within the next 15 years (exploding population growth, dependance on horses and horse-drawn carriages). Unbeknownst to the top city planners and engineers wracking their brains over this dire yet inevitable situation, the car was about to show up and fix everything.

I hope so, but so far all I've seen are assurances that Obamacare is making things better for me when in every measurable way but one it's making my life materially worse.

 

[zinfamous]

I hope so, but so far all I've seen are assurances that Obamacare is making things better for me when in every measurable way but one it's making my life materially worse.

It's the royal "you."

Yes, it has made medical care better for "you," meaning, more people than before. This is undeniable. Some get the short end...for now. It will only get better, because the insurance companies will be squeezed out by forces they can no longer control. Emergency Care is no longer the primary source for millions that had no health care before. If you are unfamiliar with this aspect of poverty, then let me tell you that the significance of eliminating emergency care as primary care is astronomical. Costs in medical care for the rest of us aren't going to be realized as quickly as say, when the prince of SA shoots under par and decides to pump 10 billion more barrels of oil to celebrate his victory, thus driving down oil prices for the next month, but they will happen, and they will be across the board, and they will be permanent.

That is a fact. Care is only getting better, and it will only get better. And it is getting cheaper and yes, you will be paying less. That is a fact.

What the fatty in the radio booth chowing on beef jerky blathers into his microphone about the ebil muslim and his healthcare really shouldn't concern you. that guy is a fucking idiot, and he will be dead of multiple infarction in ~5 years. That is a fact.

patience, I guess? :\

There was a time in this country when we were all in this shit together. Now, no one seems to give a good goddamn about their neighbor. Thanks, Reagan!

 

[Zorkorist]

Zinfamous,

You seem to imagine, that now that Government owns health care, that waiting times at hospitals, for stubbed toes, will go down.

Why would you think that?

Health care is already socialized by insurance companies and Government. It has been for years. Do you expect inner city hospitals to become this clean place that schedules health care, versus the triage centers they are today?

Do you expect a mother with four children, working two jobs, to take time out of her day to visit a general practitioner?

What little miracle of socialism do you imagine Obama Care to be?

-John