*rant* insurance companies and the US healthcare industry can kiss it

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kt

Diamond Member
Apr 1, 2000
6,015
1,321
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"Freeloaders" will exist with or without universal healthcare. We already have plenty of "freeloaders" in this country. Poor people who qualify for Medicaid pay zero for healthcare. And almost all get some sort of health insurance premium subsidy through work, state health insurance exchanges, or through Medicare. The truly fucked are the subset that don't fit into any of these while still subsidizing the rest.
There lies the problem that we are so obsessed with the need to put a label on those who are less fortunate. Are you truly fucked though if you don't fit into any of these situation but still come out ahead of most people out there?
 

dank69

Lifer
Oct 6, 2009
36,125
30,518
136
When the CBO estimates we can save $650B by going to Medicare For All we all need to understand that means going to Medicare For All will remove $650B in profit from our healthcare system. Now you know why we don't have it yet. Now you know that every representative that attacks M4A cares about profit more than they care about you. Now you know who not to vote for.
 

IronWing

No Lifer
Jul 20, 2001
70,210
28,913
136
My favorite new medical trick is a provider sending bills straight to collections w/o billing us directly or submitting claims to the insurance. If we were dumb enough to pay the collection agency, the provider would make more money as the bullshit "list" price is far higher than the insurance company negotiated rate. So even after the collector takes their cut, the provider makes more money via the collections channel than through insurance. I haven't researched it yet but it would surprise me not if the collection agency is owned by the provider.
 

MtnMan

Diamond Member
Jul 27, 2004
8,960
8,191
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I'm just glad I'll be eligible for Medicare in roughly 6 more years.... hopefully I'll survive until then!

:oops:

AND the travesty is that unless you buy expensive "gap" insurance Medicare doesn't fully cover a whole lot of stuff, however usually it's the care-PROVIDER (Doc and/or hospital) that gets screwed by this after the fact.
Part D, drug coverage, is the ticking time bomb for most medicare recipients.

I've been on Medicare with a supplemental for 12 years now. Had a couple of not so good years' health wise, but even with half a million in total charges one year, my out-of-pocket was all I paid ($149 at the time, now $233). I don't even have to pay copay's for doctor visits.

My greatest fear is that at some point I would need an expensive drug, and that is the healthcare cost that could devastate me financially, even with Part D coverage, and that is 100% the result that big pharma own enough congress critter to write their own ticket. They even got laws passed that forbid the government from even trying to negotiate a better or more competitive price on drugs.
 

Captante

Lifer
Oct 20, 2003
30,316
10,814
136
Part D, drug coverage, is the ticking time bomb for most medicare recipients.

I've been on Medicare with a supplemental for 12 years now. Had a couple of not so good years' health wise, but even with half a million in total charges one year, my out-of-pocket was all I paid ($149 at the time, now $233). I don't even have to pay copay's for doctor visits.

My greatest fear is that at some point I would need an expensive drug, and that is the healthcare cost that could devastate me financially, even with Part D coverage, and that is 100% the result that big pharma own enough congress critter to write their own ticket. They even got laws passed that forbid the government from even trying to negotiate a better or more competitive price on drugs.


Right now I take Eliquis aka: Apixaban which is a blood-thinner.

It isn't yet available as a generic (thanks for that Pfizer!) and currently it costs me zero thanks to state Medicaid however full retail price is over $500 for a 30-day supply of name-brand.

And the really crazy part is that $500 is nothing for brand name meds.

Thing is that aside from other anti-coagulants Eliquis has very few interactions or dietary restrictions plus a readily available "antidote" in case of uncontrolled bleeding so I REALLY don't want to switch when I have to get private insurance again.


EDIT: To be fair Pfizer does offer a substantial discount through a program accessible on their website to those with private insurance but still not cool.
 
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ponyo

Lifer
Feb 14, 2002
19,688
2,810
126
There lies the problem that we are so obsessed with the need to put a label on those who are less fortunate. Are you truly fucked though if you don't fit into any of these situation but still come out ahead of most people out there?
I'm just repeating the word you used. And if you want to volunteer and join the truly fucked group, the government and the insurance companies will be happy to accommodate you.
 

ponyo

Lifer
Feb 14, 2002
19,688
2,810
126
Part D, drug coverage, is the ticking time bomb for most medicare recipients.

I've been on Medicare with a supplemental for 12 years now. Had a couple of not so good years' health wise, but even with half a million in total charges one year, my out-of-pocket was all I paid ($149 at the time, now $233). I don't even have to pay copay's for doctor visits.

My greatest fear is that at some point I would need an expensive drug, and that is the healthcare cost that could devastate me financially, even with Part D coverage, and that is 100% the result that big pharma own enough congress critter to write their own ticket. They even got laws passed that forbid the government from even trying to negotiate a better or more competitive price on drugs.
Medicare is like Social Security. I don't see government messing with it since too many seniors vote.
 

kt

Diamond Member
Apr 1, 2000
6,015
1,321
136
I'm just repeating the word you used. And if you want to volunteer and join the truly fucked group, the government and the insurance companies will be happy to accommodate you.
I am not sure what you're advocating. Are you happy with status quo, or do you want everyone to fend for themselves? Fuck the poor, for being poor?
 

IronWing

No Lifer
Jul 20, 2001
70,210
28,913
136
Medicare is like Social Security. I don't see government messing with it since too many seniors vote.
Which is to say that it is a wildly popular program and strong voting issue among those covered. It is telling that politicians don't jump on the chance to be the ones who extend a wildly popular program to even more voters.
 
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ponyo

Lifer
Feb 14, 2002
19,688
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I am not sure what you're advocating. Are you happy with status quo, or do you want everyone to fend for themselves? Fuck the poor, for being poor?
Why would I be happy to pay more to get less? I'm for universal healthcare and always have.
 
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Captante

Lifer
Oct 20, 2003
30,316
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You might not think that then.


My grandfather (RIP) once told me that he never once gave a thought to turning 95 years old.... until one day he woke up and found himself to be 94 years old! (At that point 95 was suddenly looking good!)

He lived to 97.... NEVER wish away a single day of your life! ;)
 
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Torn Mind

Lifer
Nov 25, 2012
11,897
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Don't have time to get into details now(dealing with a two-faced city government called Gaithersburg related to a dog going at large, and boy do they love protecting snitches), but yeah it does suck.

HOWEVER, do not get your hopes up if government also becomes a "company" in the playing field. They too can play the denial game.

And as far as physical health goes, neither public nor private entities want the collective to suddenly have smaller, healthier appetites. Can't get paid if people take care of themselves. Can't do ethical science if people take care of themselves. Can't get as tax revenue if people take care of themselves.
 

kt

Diamond Member
Apr 1, 2000
6,015
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Why would I be happy to pay more to get less? I'm for universal healthcare and always have.
I wasn't sure because the way you said it made it sound like "got mine, f you" mentality. Good to hear that you're for universal healthcare, but you have to get over the fact that you may end up putting more into the system than someone who is barely getting by. If we have that resentment, it's never going to work.
 
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TheVrolok

Lifer
Dec 11, 2000
24,254
4,090
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American "Healthcare" is absolutely disgusting. It is rage inducing. Unfortunately, I just don't see how a (practical) solution. Politics and dark money are just too far gone and as has already been said, the current system makes a lot of businessmen and investors very very wealthy.
 
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PowerEngineer

Diamond Member
Oct 22, 2001
3,566
736
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While now grateful for the Medicare coverage I have aged into, I do not see the logic in providing affordable single-payer medical coverage to only so-called senior citizens. With all the push back on the Affordable Health Care Act I realize that immediate, sweeping change is beyond this country's ability, but perhaps we can start moving in the right direction by lowering the qualifying age for Medicare by two years every 4th of July.
 
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ponyo

Lifer
Feb 14, 2002
19,688
2,810
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I wasn't sure because the way you said it made it sound like "got mine, f you" mentality. Good to hear that you're for universal healthcare, but you have to get over the fact that you may end up putting more into the system than someone who is barely getting by. If we have that resentment, it's never going to work.
Current system doesn't benefit me. It harms me. So I'm looking out for myself. I already put more into the system than someone who is barely getting by under the current system. It's not resentment, it's reality. Since I'm part of the truly fucked group, I would like to move up to "got mine, f you" group like some privileged people are part of. So I want universal healthcare as I see that as improvement over the current broken system.
 

kt

Diamond Member
Apr 1, 2000
6,015
1,321
136
Current system doesn't benefit me. It harms me. So I'm looking out for myself. I already put more into the system than someone who is barely getting by under the current system. It's not resentment, it's reality. Since I'm part of the truly fucked group, I would like to move up to "got mine, f you" group like some privileged people are part of. So I want universal healthcare as I see that as improvement over the current broken system.
So, in reality you have resentment. Does that carry over whether you are paying more into the current system, or under universal healthcare? Let me ask in a different way, what improvements do you see in universal healthcare over the current broken system?
 

ponyo

Lifer
Feb 14, 2002
19,688
2,810
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So, in reality you have resentment. Does that carry over whether you are paying more into the current system, or under universal healthcare? Let me ask in a different way, what improvements do you see in universal healthcare over the current broken system?
I have the same resentment OP and the rest of you have who feel like they're paying too much for largely ineffective pricey health insurance. So if I have resentment, so do you.

What improvements do I see in universal healthcare over the current system? I see the privilege who have Medicare and know their health insurance is better than what I have. My mom is on Medicare and it's leagues better than my insurance while she pays significantly less than me. So I would like to see something like Medicare for all instead just available to the privileged portion of the population. And I would like to see better dental coverage but that might be pushing it as even in countries with universal healthcare, dental coverage is subpar. Even with my mom's superior Medicare coverage, it basically covers nothing for dental so I paid over $50k last year so she could get some new teeth implants and bridges.
 

Hail The Brain Slug

Diamond Member
Oct 10, 2005
3,497
2,443
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Right now I take Eliquis aka: Apixaban which is a blood-thinner.

It isn't yet available as a generic (thanks for that Pfizer!) and currently it costs me zero thanks to state Medicaid however full retail price is over $500 for a 30-day supply of name-brand.

And the really crazy part is that $500 is nothing for brand name meds.

Thing is that aside from other anti-coagulants Eliquis has very few interactions or dietary restrictions plus a readily available "antidote" in case of uncontrolled bleeding so I REALLY don't want to switch when I have to get private insurance again.


EDIT: To be fair Pfizer does offer a substantial discount through a program accessible on their website to those with private insurance but still not cool.

I, too, take Eliquis and every time I drop one on the floor I think about how they cost $5 each and dust it off. Fortunately it's not an outrageous copay on my insurance and I qualify for the discount program so I only pay $10 a month.

At one point my copay was $255 a month and the discount program still took it to $10. Its very telling they can just magically discount it $245 to make sure I still take it, so they can rake in the other $250 from the part my insurance pays.

Even if your private insurance plan doesn't want to cover it you can usually get it covered as a continuation of therapy since you've already been taking it. Usually when that happens the copay is outrageous (it's why mine was $255) so that discount program is going to really come in handy.
 
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MtnMan

Diamond Member
Jul 27, 2004
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You might not think that then.
At the point you are eligible for Medicare, and Medicare is not there, you have options;
  1. Be outrageously wealth so you can afford healthcare
  2. Continue to work for healthcare coverage through the workplace
  3. Be a charity case at the local hospital.
  4. Take advantage of clinics for the destitute some charities' setup.
Oh, by the way Medicare, with a supplement, is better than coverage I had prior. No calling a call center to get permission to see a specialist, no asking them to review a claim initially rejected. No co-pays, no 'up front' money for treatments. I know my total out-of-pocket for the year. This year it is $233, and I've already paid that for this year.

My only fear is prescription cost. Currently, my meds are minimal, and generic, and cost me nothing beyond what I pay for part D. However, the wrong diagnosis can easily result in thousands per month in Rx costs. This is all thanks to the greed of big pharma, and the absolute cowardice of congress critters to do anything.

This is not just a Medicare problem, every person in the country is under the threat of bankruptcy to pay for a drug to save their life or keep them alive, regardless of coverage.
 
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MrSquished

Lifer
Jan 14, 2013
23,079
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I have the same resentment OP and the rest of you have who feel like they're paying too much for largely ineffective pricey health insurance. So if I have resentment, so do you.

What improvements do I see in universal healthcare over the current system? I see the privilege who have Medicare and know their health insurance is better than what I have. My mom is on Medicare and it's leagues better than my insurance while she pays significantly less than me. So I would like to see something like Medicare for all instead just available to the privileged portion of the population. And I would like to see better dental coverage but that might be pushing it as even in countries with universal healthcare, dental coverage is subpar. Even with my mom's superior Medicare coverage, it basically covers nothing for dental so I paid over $50k last year so she could get some new teeth implants and bridges.

What exactly do you mean that something like medicare for all is only available to the privileged portion of the population?