o/t health care vent/question regarding medicaid: i have health insurance but still cannot afford healthcare...
my dh and I have health insurance through his job. I went for x-rays several months ago and I need physical therapy for my back and surgery for my hand. my cost for those x-rays alone was over $600. i'm still paying on them. forget about physical therapy for now, it's going to take me a long time to save the money for that and surgery is even further out. am I correct that someone on Medicaid (who earns less money than I) would not only have their xrays and physical therapy paid for, but would be able to have this surgery without saving their pennies as I am forced to do?
also, i understand that obamacare is supposed to make health insurance "affordable" for some people who aren't eligible for Medicaid (although Medicaid guidelines are much more relaxed), but I've heard the deductible is so high, will they even really be able to use it?
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i will do that. thanks.
i will do that. thanks.
^^^This. I used to work in a
^^^This. I used to work in a medical billing office. For patients who did not have insurance, their bill was reduced 50%.
And like LadyFace says, those costs don't just disappear, they're passed onto insured patients. It's estimated we pay an extra $1,000 a year in health insurance premiums to cover uninsured patients. http://abcnews.go.com/Business/story?id=7693848&page=1
Obamacare doesn't go far enough. We need a single payer system, so the cost is spread out far enough.
Yeah, but are the costs for
Yeah, but are the costs for uninsured actually "reduced" or are the amounts that insurance companies are billed inflated??
Insurance companies are
Insurance companies are contracted for far less. FAR less.
Hospitals, phyicians and other anicillary providers typically submit bills that are priced at 200% of what Medicare allows for the procedure on thieir fee schedule.
Insurance companies negotiate rates with providers, depending on how good the provider is/ how in demand their services are this can range from 75% of Medicares fee schedule up to 125% or 130% of Medicares fee schedule.
When the insurance company pays: The difference between 'billed charges' and the 'contracted rate' is WRITTEN OFF as a 'contractual adjustment".
So now take a self pay patient. Who is paying cash and gets 50% lopped off their bill.
That means they are actually paying the same amount of money for their bills as Medicare does and MOST insurance companies in existance.
Yeah. It's a game of numbers.
And lets not forget this:
Most providers allow that discount IF you pay the bill IN FULL at the time of service (or on the first billing cycle).
If you have insurance, it gets billed if you have a large deductible and owe your doctor $600.00 they WILL let you make payments: normally interest free. Self pay patient does not get that free gift. Not and still keep the discount, if they need payments they will be paying the FULL amount of the charges aka twice what the insurance companies pay.
So yeah, healthcare needs to be fixed, but Obama care is a band aid.. and most people are going to find that it is not helping them heal any faster and many will likely have an allergy to the adhesive.
Your higher premiums are not
Your higher premiums are not just due to the uninsured or under insured.
Smoking
Obesity
Uncontrolled diabetes
People using ER's as their PCP instead of getting routine care.
It all adds up.
I am a smoker. I pay a ton
I am a smoker.
I pay a ton in taxes for my 'habit' and get to pay higher premiums for my health insurance and life insurance due to my CHOICE of smoking.
If someone wants to suck down 2 liters of soda a day, a twice a day Mc donalds habit, a couch potato habit etc: let them pay the same 'taxes' for their CHOICES as I do.
Maybe if a 2 liter of soda cost the same as a pack of cigarettes obesity would do down. Eliminate dollar menu's at fast food places, outlaw childrens meals at the same establishments, add a 'shitty diet' tax to their food costs and watch how fast their "More than a gazillion sold" signs come down.
But here is the problem: In a nut shell
1) Too many people allowed to use social welfare as a career instead of the hand up it is supposed to be.
Solution: Max time limits on all services. You get six months. And done. Must be off the payroll for 48 months to reapply.
And for the 6 months your on it: Mandatory volunteer work. 40+ hours a week picking up litter off the side of the road, refusal = bennies termed.
** Exception: Someone with a true, documented disability.
2)
Minimum wage SUCKS.
Cheap (read crappy) food is cheaper than nutricious food.
If your making under $10.00 an hour can you afford a roast to feed your family with? With all the fresh veggie trimmings?
Or are you grabbing a pound of hamburger for $3 a box of ham helper for a buck and IF you have the money another $0.69 for a CAN of some kind of vegetable that was likely picked sometime during ww2?
Solution: Unkown how to accomplish, but make nutricious foods AFFORDABLE.
3) Most of the population of this world is attracted to the 'new' and have become lazy. They Want and they can justify that WANT into a NEEEEEDDDD!!
No one NEEDS an iphone. Any crappy cell phone works. But no we must have the 4g! And touch screen, wait this model can start my coffee for me remotely in the morning, operates as a nanny cam, can pay my bills if I blink twice, walk the dog at midnight.. blah blah.
No one HAS to have a new car:
A used car works too..and face it replacing an engine or trannie is FAR cheaper than the cost of a new car.
Oh but the new car as all these fancy gadges... GPS, Siri, Satellite Radio, heck they even have them now adays that can literally park themselves.
Don't get me started on the 22 inch rims, stupid ass lift kits, specialty paint jobs etc etc etc.
Honestly, what we need is a good old fashioned luxury tax. And slap that tax on everything that isn't healthy and isn't a necessity.
Or hey, a stupidity tax would work better. If they enforced that sucker as hard as they enforce CS on some dads the national debt would be paid off in a week.
There's some sort of voucher
There's some sort of voucher that can only be used for fresh fruits and veggies. There's a farmer's market from local farms in my neighborhood that takes those vouchers so i see everyone who is on this voucher going there to pick up veggies.
Or doing a little searching--Aldi has seasonal fruits and veggies for SUPER cheap. A pound of tomatoes is a dollar, a bag of onions of $79 cents etc.
Or the chinese supermarkets which have fresh fruits and veggies at literally pennies.
Oh Hell no. Sorry, no
Oh Hell no.
Sorry, no presidency for me. I am NOT politically correct. Unless America wants to hear their president ask congress, on national tv:
Are you honestly as fucking stupid as you make yourself appear to be??
or
WTF is wrong with you... did you skip every fucking math class from Kindergarden through college?
or
Seriously, dude, extract your head from your ass.
or
How the fuck did you live this long being that stupid?
or
"No dumb ass, I am not signing a bill to pay $1b for a fucking bridge that leads no where"
We don't EVEN want to go into what I would be telling some of our 'allies' or those nations who we support utterly aside from "Gravy Train OVER".
Yep, and on top of that, I'm
Yep, and on top of that, I'm now paying for subsidies too. My paycheck, which I kind of need to pay my own bills, is being eaten up in part due to legislation that many US Senators/Representatives didn't read. Heck, the speaker of the house didn't even read it. She was one of its biggest proponents.
You and me. And I don't mind
You and me. And I don't mind helping anyone, but I'd like to get to choose who I help.
Where does it end? We've been
Where does it end? We've been forced to help for the "less fortunate" since LBJ's Great Society (and even before that).
Title 18 and Title 19 Better
Title 18 and Title 19
Better known as Medicare and Medicaid.
Well, he signed Medicare into
Well, he signed Medicare into law. And without Medicare, we wouldn't have this gem, which only creates more bureaucracy. And whether you care to admit it or not, poverty has more than doubled since his "Great Society."
They outsource because it's
They outsource because it's cheaper to do the work there, and there are less regulations in the name of "fairness."
If people want to make money, including people who run these "evil" corporations, what's the problem with that?
Cocoa: also check your local
Cocoa: also check your local state health insurance coverage. Florida has a low cost program for those who do not qualify for Medicaid but need insurance.
Its through BCBS and depending on income is what your monthly premium is: Can be as low as $25 a month for an entire family. Its HMO coverage, low copays and BCBS has a huge network of physicians etc in Florida.
It might be an option for you if your state has one as well.
Tog I agree with you that something HAS to be done, however, Obama Care is a MESS. I actually sat down and tried to read the bill. Its poorly thought out, impossible to follow and here is the kicker: They have not contracted with ANY physician, hospital, lab etc. All these new policies being written are a new type of policy, not your average ppo,pos,hmo. Providers are contracted with insurance companies and have to contract per plan type (so have to agree to be providers for HMO, PPO, POS and hammer out their contracted fee schedules-- how much they are going to get paid for seeing patients).
Not a single provider I have spoken with has been approached to provide services for the Obama plans and most of them state they will not contract for the plans. Period.
Oh gees. Why do you think you
Oh gees. Why do you think you know what we need. I do not need to pay for others' health care. I want to pay for my own health care and have the option to choose whether or not I buy insurance.
Nobody knows what that crap does anyway. what we do know is that we cannot sustain it. What I do know is that I cannot afford everyone. What I do know is that because I pay my bills, I am now penalized via a very high tax to pay for others.
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excellent post!
Check out healthcare.gov or
Check out healthcare.gov or contact your US representative/senators.
If my BS3 were to need
If my BS3 were to need braces, my work insurance would only pay a fraction of the cost, I would be responsible for the rest. But both skids who's scumbag mother's have free government insurance got FREE braces... paid for by you and me.
I seriously hate this crap. If I wasn't so damn proud, I would quit working and just live off of everyone else. Seems to be the cool thing to do nowadays.
"If I wasn't so damn proud, I
"If I wasn't so damn proud, I would quit working and just live off of everyone else. Seems to be the cool thing to do nowadays.
"
Same here.
Yes I do. And I also realize
Yes I do. And I also realize that we also are near defaulting for many reasons, this being one of them. Yes, every industrialized country offers health insurance to all their citizens. Just look at what a great financial state they're in-especially the uk. Things almost passed the brink there a few years ago.
there are people of there
there are people of there that work 2 and 3 jobs and still can't afford basic health insurance?
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Can they really not afford it or do they just not want to PAY for it?
"You are taking other
"You are taking other people's money."
And what are the folks on benefits in this country doing? They're not paying for those benefits. We are. So they're taking our money, which they've done nothing to deserve.
And what sucks even more, is
And what sucks even more, is PAYING for health insurance, only to find out it doesn't cover the procedure you need.
Good post by JHW explaining
Good post by JHW explaining contractuals!
I do deal in this every day... and it's exhausting.
These days hospitals really have nowhere to upbill (meaning, billing one insurance company more to make up for losses from other insurance companies).
Did you know Medicaid reimburses roughly $29 for an ED visit?
Did you know that on the average, a Medicare patient can rack up a bill for a 5-day long hospitalization costing $20,000 but because of the diagnosis requiring admission the hospital gets reimbursed roughly $8000?
And most insurers now are some sort of contracted rate -- honestly I don't know of ANY insurance company that pays 100% of billed charges anymore. If anyone knows of one, please let me know!
My own pointy headed opinion:: both Medicare and Medicaid are federally funded and run programs. They can't even get it right for THAT population... and now we're taking a chance on yet another insurance "system" that has NOT been tested on the small scale? Has not been thoroughly investigated because the actual "law" is so cumbersome?
Because of the profession I'm in, I fear that in one year, due to huge changes the government is making to billing/payment systems (not even remotely related to Obamacare) we're going to see a crash of epic proportions. The government has Never been prepared for their yearly changes to billing/payment systems that have been happening on OCT 1 of every year since 1984 for Medicare,, and MARCH 1 of every year for Medicaid... which leads to non-payment on bills for sometimes 60 days until the government can get it 'straightened out'... and now we're going to add all of the policies under the ACA into that mess? Wow.
And I guess one other thought.... why create another system (Obamacare)of insurance? If the goal is universal health coverage, then it should be ONE SYSTEM FOR ALL -- abolish Medicaid and medicare all together. Everyone gets the same healthcare, whether you're 2 or 102. Wonder if anyone has ever thought of that??
Three Rivers Provider
Three Rivers Provider Network:
Small network for about 200 different independently owned insurance companies, PHO's, self insured etc.
My current contract is for 98% of billable.
I have good insurance and
I have good insurance and good stable job that pays well and I'm thankful. I don't mind paying or helping the elderly, disabled or people that need help with mental problems.
WHAT I DO HAVE A PROBLEM is with people like my STEPDAUGHTER who keeps having baby after baby after baby and is unemployed, not married, on welfare, section 8, food stamps, medicaid, pell grants, free school lunches, free utility assistance, free obama phone and the list goes on and on and on. SHE HAS NEVER WORKED. NEVER. NEVER. She is on fb now complaining about getting up early to cook eggs and get the kids off to school so she can sit home and smoke cigarettes and watch movies. Stepdaughter has lots of friends and they are all just like this. Andy they just keep having this babies and babies they can't feed, clothes, put a roof over them, take care of them much less know who their loser father MAY be.
The GOVERNMENT IS YOUR BABY DADDY.
^^^THIS^^^ We are paying for
^^^THIS^^^
We are paying for people like your sd who "aren't healthy enough" to work, but sure are healthy enough to get f0cked left, right and sideways by guys.
I'd also like to see people
I'd also like to see people having to prove they are looking for work when they go on unemployment.
I'd like to see people on disability be categorized based on severity of their condition and what each category can do in terms of work and then be in government backed jobs to keep their disability. Can't walk? No problem, you can be a telemarketer from home! Or data entry! Or things that just require a computer! Not sit on your butt all day watching TV.
Education based benefits I think are a definite must.
Some states are definitely
Some states are definitely shit at handling it. The employees that were let go where I worked didn't have to prove anything for our state. Just a phone call confirming they were let go for the reason they said they were and that was it. Many of them just went on vacation.
I think they should find a better way to do universal healthcare. Just get rid of private companies altogether if they have to and do a government one and everyone gets taxed for it at the same percentage. Or like I said, give a tax deduction for purchasing health insurance for the working poor.
The problem also stems from our sue happy nation with malpractice insurance so high for doctors, they charge obscene amounts which in turn drives up the cost of health insurance.
This thing is just one big mess.
Those people piss you off,
Those people piss you off, but you voted for the same person they did.
Well, it's the truth. Do you
Well, it's the truth. Do you think they voted for Romney?
STEPDAUGHTER who keeps having
STEPDAUGHTER who keeps having baby after baby after baby and is unemployed, not married, on welfare, section 8, food stamps, medicaid, pell grants, free school lunches, free utility assistance, free obama phone and the list goes on and on and on. SHE HAS NEVER WORKED. NEVER. NEVER.
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Sadly I feel this is the majority of people that are on these programs. They do not want true help. They want a hand out. They really need to make a time limit you can get help from the government. 6 months tops. After that you sink or swim.
"Sadly I feel this is the
"Sadly I feel this is the majority of people that are on these programs. They do not want true help. They want a hand out. They really need to make a time limit you can get help from the government. 6 months tops. After that you sink or swim."
^^^THIS^^^
But sadly, our government does not feel that way. Why work when Big Brother will take care of you?
:sick:
PEOPLE HAVE NO PRIDE ANYMORE!
PEOPLE HAVE NO PRIDE ANYMORE! Back in my day...if you HAD to get some government help...you did it regretfully and tried not to let people know about it. You also tried to get off of it as soon as you could. NO ONE WANTED TO BE TAKING HAND OUTS.
Now...it is common place for people to be proud of how much they can get from the government and other agencies. Sickening.
Amen! 60 Minutes last night
Amen! 60 Minutes last night was about the abhorrent fraud taking place in our Disability program. This blog reminds me of this statement made on the program that rings so true:
Marilyn Zahm (Disability judge): "If the American public knew what was going on in our system, half would be outraged and the other half would apply for benefits."
For some, it's about taking pride in working to be independent. For others, it's about getting all you can get for nothing.
YES!
YES!
You know, I think they went
You know, I think they went about universal coverage all wrong.
What I'd do instead is have a tax deduction for people who prove they pay for health insurance in the middle class bracket. So they can choose to get it if they want instead of penalizing everyone.
Instead of making it a LAW
Instead of making it a LAW that EVERY person must have insurance...why didn't they just regulate the hospitals/Dr to charge more affordable rates.
Malpractice insurance for
Malpractice insurance for them is so high because we like to sue as a nation.
Medical school fees are super high too and most are still paying it off ten years in. This particular problem may be able to be solved if we had government funded programs to school and license doctors for either free or very cheap, but at least 10% of their patients have to be uninsured and they have to see them for free (but they get a tax deduction or it)
And why not have something like midwives or acupuncturists? Have healthcare professionals that have less intensive training, for smaller things like colds and sprains, etc.