Texas -- a failed state

[Dutchrudder 11141]

16 hours ago, Anastasis said:

If you want to fix the healthcare finance system in this country (or this state), you have to tackle the cost drivers of healthcare spending. Hospital systems and pharma. That’s where the profit margins are. Physician services makes up another big chunk of the spending, but the margins there don’t have much fat once you parse out the imaging and diagnostics. 

That's definitely part of it, now see if you can put the pieces together some of the solution, and then figure out which party might actually make some effort and have success in bringing down the costs. 

Hint:
Government funded and mandated healthcare that covers preventative care (checkups, vaccines, early screenings, etc) is estimated to potentially save billions of dollars. (also people wouldn't suffer as much, if that matters to you)
Letting Medicare and Medicaid negotiate medicine prices would reduce costs significantly for the US Gov. 
Mandating lower costs for life saving drugs, some that are 8 times higher than other countries, is another way of doing it for everyone. 
Eliminating the ability of drug companies to market their drugs to "consumers" would reduce pharma costs across the board. Over 8 billion was spent within the US in 2022 on ads.

 

[Biff Tannen 45691]

6 minutes ago, Dutchrudder said:

Eliminating the ability of drug companies to market their drugs to "consumers" would reduce pharma costs across the board. Over 8 billion was spent within the US in 2022 on ads.

And I do believe we are the only country that allows this.  Used to be anyway.

[atomheartbevo 89732]

3 hours ago, Fudge Nuggets said:

Next time, say the last part first. 
What a beating. 

From reading their websites, it's a whole bunch of white dudes (no surprise) upset that Texas is not what they wanted (and it seems more than a few of them are not even native Texans).  They also have quite a few sovereign citizen types in their ranks, which they bitch doesn't go over well with local cops/judges.

This is really what they want

56 minutes ago, C-Man said:

Ground zero for the American Redoubt is in northern Idaho. Lots of white extremist groups up there.

 

[royiv 9326]

5 minutes ago, Dutchrudder said:

Eliminating the ability of drug companies to market their drugs to "consumers" would reduce pharma costs across the board. Over 8 billion was spent within the US in 2022 on ads.

 

Agree with everything you posted, but quoting the last point because it's so particularly disgusting. There's no reason prescription drugs need to be marketed to consumers. If you really want to be disgusted, the next time you're watching TV, start googling the cost of some of these drugs that are being marketed to consumers. A good chunk cost five or six figures per cycle.

[Anastasis 23475]

16 minutes ago, Dutchrudder said:

That's definitely part of it, now see if you can put the pieces together some of the solution, and then figure out which party might actually make some effort and have success in bringing down the costs. 

Hint:
Government funded and mandated healthcare that covers preventative care (checkups, vaccines, early screenings, etc) is estimated to potentially save billions of dollars. (also people wouldn't suffer as much, if that matters to you)
Letting Medicare and Medicaid negotiate medicine prices would reduce costs significantly for the US Gov. 
Mandating lower costs for life saving drugs, some that are 8 times higher than other countries, is another way of doing it for everyone. 
Eliminating the ability of drug companies to market their drugs to "consumers" would reduce pharma costs across the board. Over 8 billion was spent within the US in 2022 on ads.

 

Agree strongly wrt DTC advertising and I would go much further than most wrt restricting marketing activities. Agree that pharma pricing needs pressure applied. I think that the best approach is removing the various clouds and letting a competitive market shake it out, but there are certainly good arguments for leveraging government buying power in certain situations. We should also require health economic and cost effectiveness analyses as part of the approval process, in the same way the they do in UK and some european markets. It is part of a reasonable price finding process imo. Preventative care is a drop in the bucket and could/should be part of a revisioned Medicare backstop, jsut like it is with HDPs today,.   

[Dutchrudder 11141]

17 minutes ago, royiv said:

Agree with everything you posted, but quoting the last point because it's so particularly disgusting. There's no reason prescription drugs need to be marketed to consumers. If you really want to be disgusted, the next time you're watching TV, start googling the cost of some of these drugs that are being marketed to consumers. A good chunk cost five or six figures per cycle.

I saw a stat that said 20% of total US pharma spending is made up of mostly generic drugs, and the other 80% is all these fancy new ones that have commercials and huge ad campaigns. I'm sure the 2023 numbers will be astounding once the data on the fat blocking drugs like Ozempic are made available. I can't watch anything without seeing ads for them. And if you look into the purpose and requirements of those drugs, they really don't do what people think they will do. It's truly sad how misleading they are, or how they lie by omission of who would normally qualify for a prescription.  

18 minutes ago, Biff Tannen said:

And I do believe we are the only country that allows this.  Used to be anyway.

The US and New Zealand are the only modern countries I know of.  The problem with making it illegal is that politically you would not only be fighting against Big Pharma, but also all the companies that rely on those advertising dollars. There would be quite a coalition of companies pushing back from all directions.  

[Walser 1109]

8 hours ago, Nice Guy Eddie said:

The worst part of the dropped medicaid recipients info are the Texans who high five each other about that news. Like what would happen on TexAgs. But they’re morons.

this increases the costs to the Texas taxpayer. Do you think most of former Medicaid recipients are going to magically find health insurance options? No they will use ER services even that much more. Which makes that person even poorer which isn’t a win for Texas. This will put even more stress, financially and operationally, on our already stressed health system.

when you have a 8 hour wait at your local ER, thank Greg for it.

I had to go to the ER about six months ago with a fairly urgent need. (turned out fine) On the advice of a family friend I went to a more central Austin hospital. I was the only one there with any kind of urgent need.

I waited a long time nearly passing out as person after person went up with a minor cough. When my turn came they didn't even bother asking me for insurance though I had my card out. It was eye-opening.

I was hospitalized for a couple days. One early morning someone came to my door saying they were ready to take me for surgery. It took a little while to convince them I wasn't having surgery though they showed me the form with Mr. Walser on it. Though it likely put a damning entry on my patient note (a la Seinfeld) I checked myself out shortly afterwards.

[Biff Tannen 45691]

4 minutes ago, Dutchrudder said:

The problem with making it illegal is that politically you would not only be fighting against Big Pharma, but also all the companies that rely on those advertising dollars. There would be quite a coalition of companies pushing back from all directions.  

Medical professionals would be praising jeebus.

[Zepol87 9188]

1 hour ago, royiv said:

Agree with everything you posted, but quoting the last point because it's so particularly disgusting. There's no reason prescription drugs need to be marketed to consumers. If you really want to be disgusted, the next time you're watching TV, start googling the cost of some of these drugs that are being marketed to consumers. A good chunk cost five or six figures per cycle.

I just thought this was normal until about a decade ago when some friends from Spain and Germany came to visit and we partied a bit one night and they were talking about how crazy it was that we had all the drug commercials. I had no idea that wasn't normal everywhere

[RDCanecutter 26452]

Oh Oh Oh Ozempic.

[gmr548 16580]

12 hours ago, royiv said:

It goes further than that. Those ER visits don't just pay for themselves. The taxpayers and commercially insured end up subsidizing those losses through higher healthcare premiums. Not providing coverage to the poor ends up costing all of us more in the long run. 

Yep. This country already has universal healthcare. We just do it in the most expensive, lease effective way possible.

[fattyflattie 4639]

8 hours ago, Chewbacca said:

So you contribute to winning by turning your state into a shithole people don't want to live in?  Interesting choice there.  I'd rather make my state somewhere people want to live.  Oh, wait, it already is.

A little bit of heat and the inability to instant abort your one nighter doesn’t make a state shitty. Contrary to the whining on this board.  

[YChang 3453]

Ooomph… getting hard to assume positive with that comment. 

[fattyflattie 4639]

10 minutes ago, YChang said:

Ooomph… getting hard to assume positive with that comment. 

The law that most of the upset people are most upset with?  

[YGIFS 19452]

Instant abort?  I thought the issue was all these women having late-term and post-birth abortions?  

And if 110* for 3 months straight qualifies as a "little heat", I don't think you have to worry about being menopausal yet.  So get out there and fuck/abort to your heart's content   

[elfenix 34312]

43 minutes ago, fattyflattie said:

A little bit of heat and the inability to instant abort your one nighter doesn’t make a state shitty. Contrary to the whining on this board.  

the prior regime was the inability to instant abort your one nighter.  the current regime is the inability to abort your certain to be DOA brain-outside of skull failed pregnancy which is going to threaten your life and fuck up your ability to become pregnant ever again. a 3x higher maternal death rate than in states without such draconian laws is such a thing to be proud of.

 

 

but i know, i know, you can't have a good faith discussion in CR with penelope negging you constantly.

[fattyflattie 4639]

1 minute ago, elfenix said:

but i know, i know, you can't have a good faith discussion in CR with penelope negging you constantly.

Eh, it’s more of a nuisance than anything.  The rep is typically returned on the hobbies board in the same day. 

[elfenix 34312]

*claims to hate people on the dole, supports policies that demonstrably result in more people on the dole*

[CTC2 2797]

14 hours ago, royiv said:

It goes further than that. Those ER visits don't just pay for themselves. The taxpayers and commercially insured end up subsidizing those losses through higher healthcare premiums. Not providing coverage to the poor ends up costing all of us more in the long run. 

Check out what happened after Obamacare. More people with coverage, the increased  recoveries and narrowed that gap.  But, more people having access to health insurance is apparently bad. 

[BevoAbyss 2059]

On 11/27/2023 at 10:18 PM, Satchel said:

Texas is no longer a business friendly state, then what the hell is it,

What the hell is Texas? Texas is a 21st century Rome with:

-- Endless gladiatorial spectacles for the masses.

-- Grand architecture for people to work in and gather around. 

-- Conspicuous displays of wealth, privilege, and consumption ... along side soul-sucking poverty. 

-- Widespread worship of those with wealth.

-- Chariots in the form of flashy cars, trucks, SUVs.

-- Rampant corruption and conspiracy theories.

-- Electronic versions of stone tablets and papyrus for mass media.

-- etc etc etc.

Only the Christians & fascists have seized political power and are busy:

-- Throwing to the lions pregnant women, immigrants, poor people, people of color, LGBTQIA, and other groups in the future. 

-- Building megachurch temples and rewriting history with their creation museums, bible schools, book bans, anti-science, etc. 

-- Building walls to secure their glorious eternal empire.

-- All supposedly for their unseen god's promise of a divine destiny. 

In other words, Texas is a giant mirror of America, a 21st century Rome.

Edited November 29, 2023 by BevoAbyss
Typos.

[Judge Roybeanbag 11819]

9 hours ago, YGIFS said:

Instant abort?  I thought the issue was all these women having late-term and post-birth abortions?  

And if 110* for 3 months straight qualifies as a "little heat", I don't think you have to worry about being menopausal yet.  So get out there and fuck/abort to your heart's content   

Frankly between summer heat exhaustion, freezing to death in the winter when the grid goes down, starving because the SNAP program isn’t working and not being able to access Medicaid, I’m sure plenty of unborn babies are dying regardless.  Oh yeah, check the stats, infant mortality rates are up over 10% after the ban.  Good call, GQP!

[YGIFS 19452]

Also, not sure how to measure this so I'll leave it to proper scientists and data experts...you know that thing that Texas does super good!  But, I would imagine some of the literal 'damage' being done to some of these mothers being forced to carry unviable pregnancies to term will greatly impact their ability to have viable, healthy pregnancies later in life.  I'm guessing this hodge podge approach to "pro-life" is going to leave hundreds, if not thousands, of women each year in Texas with fucked up reproductive systems because of this new policy.  I know our second D&C wrecked my wife's tissue and we had to get another procedure done after that, plus meds, plus wait another 6+ months after all that to start trying again.  Which isn't a big deal to some, but 6+ months is  big fucking lag time when you're already in your late 30's.  And that was before all this draconian shit was set into motion.  

You worried about declining population?  Worried about the ability to generate new life in God's image?  Quit fucking up women's lady parts!  35% of you don't even know how the hell menstrual cycles work, and you want to dictate the future of every woman's, even after a doomed pregnancy?  I'm not saying you have to be an OBGYN or PhD in Theology to have an opinion on abortion/pro-life/reproductive rights, but maybe stop for 10 seconds and think about what all this "pro-life" procedural clout is doing to some women long term.  You're not saving a life, you're wrecking multiple ones.  

[atomheartbevo 89732]

3 hours ago, BevoAbyss said:

What the hell is Texas? Texas is a 21st century Rome with:

-- Endless gladiatorial spectacles for the masses.

-- Grand architecture for people to work in and gather around. 

-- Conspicuous displays of wealth, privilege, and consumption ... along side soul-sucking poverty. 

-- Widespread worship of those with wealth.

-- Chariots in the form of flashy cars, trucks, SUVs.

-- Rampant corruption and conspiracy theories.

-- Electronic versions of stone tablets and papyrus for mass media.

-- etc etc etc.

Only the Christians & fascists have seized political power and are busy:

-- Throwing to the lions pregnant women, immigrants, poor people, people of color, LGBTQIA, and other groups in the future. 

-- Building megachurch temples and rewriting history with their creation museums, bible schools, book bans, anti-science, etc. 

-- Building walls to secure their glorious eternal empire.

-- All supposedly for their unseen god's promise of a divine destiny. 

In other words, Texas is a giant mirror of America, a 21st century Rome.

Username checks out.

Also

[Disco Strangler 1878]

Somebody apparently thinks about the Roman Empire on a frequent basis.

[texasdago 7575]

On 11/27/2023 at 10:26 PM, DalTxHornFan said:

Obamacare, much?

Tell me DalTx.  Have you gotten a colonoscopy yet?  Serious question... not a weird "stick it up your ass" question.

[Dutchrudder 11141]

17 hours ago, Anastasis said:

Agree strongly wrt DTC advertising and I would go much further than most wrt restricting marketing activities. Agree that pharma pricing needs pressure applied. I think that the best approach is removing the various clouds and letting a competitive market shake it out, but there are certainly good arguments for leveraging government buying power in certain situations. We should also require health economic and cost effectiveness analyses as part of the approval process, in the same way the they do in UK and some european markets. It is part of a reasonable price finding process imo. Preventative care is a drop in the bucket and could/should be part of a revisioned Medicare backstop, jsut like it is with HDPs today,.   

Is any political party trying to actively address these issues and provide more healthcare to everyone? 

Is one party trying to address at least some of the issues more than the other?  

Is one party focusing on providing that preventative care to as many people as possible, while the other is actively removing access, funding and basic coverage? 

Would one party's plan for healthcare significantly reduce the over-use and abuse of our Emergency Rooms as free clinics?

Is one party attempting to criminalize medical procedures, which would have otherwise been perfectly legal a couple years ago, and therefore driving up costs for providers and the costs for everyone?

If you think we need something more akin to the Single Payer style system that the UK has (due to the cost benefits, pooling of resources, negotiating power, etc), who or what party would get us closer to that?  

 

I normally wouldn't advocate for so much government control in a public industry sector, but the nature of the care and necessity to control costs requires a Big Brother type presence for many without the means to advocate on their own behalf. The Free Market approach simply doesn't work when the consumer often doesn't have choices, and there are a million stories of people riddled with debt out there for examples. After a car accident, the ambulance driver isn't going to ask you what hospital is in-network for your insurance. You don't get to shop around your emergency care, you generally don't get to pick and choose what you pay for at the hospital, because they want to ensure a base level of care. Plus medical providers have a duty to ensure a certain level of care that often does require sometimes excessive caution, but it's necessary to ensure the highest level of success for all patients. The Free Market works great when ordering a burger, but in the medical cases you're often only able to choose whether you want ketchup or mustard, and the burger still costs $5,000 either way. 

A lot of prescription drugs don't have good alternatives for a variety of reasons, which can cause people to have to choose between medicating and basic necessities. It's a captive audience in a lot of these cases, and some are where the cost is so much that the person afflicted could be thrown into a debt spiral that weighs them and their family down for years. The more government can do to help everyone survive unexpected catastrophes, get healthy, recover successfully and do so without ruining their lives financially, is a significant benefit to society. It's not just the wellbeing of the individual, but also the the family, their home life, their children, etc. That's part of having a functioning society, advocating for the little guy, and to do so would require replacing the gigantic worthless middle-man that is Health Insurance industry of America (they made over 22 billion in PROFITS last year!).  

[Nice Guy Eddie 13515]

1 hour ago, Dutchrudder said:

After a car accident, the ambulance driver isn't going to ask you what hospital is in-network for your insurance. You don't get to shop around your emergency care, you generally don't get to pick and choose what you pay for at the hospital, because they want to ensure a base level of care.

You don't pay any more for care for similar emergency services at an out-of-network hospital. Now does every ER treat you the same? I'm sure some may order unnecessary tests but I don't believe for a second that most ER doctors are told to order unnecessary tests.

Quote

The Free Market approach simply doesn't work when the consumer often doesn't have choices, and there are a million stories of people riddled with debt out there for examples.

I don't understand why medical debt is somehow viewed as a shortcoming of the system. Is it better than someone has debt for their boat but not have debt to save the life of their child? If it means I'm alive, take all of my money.

While admittedly I don't know this for certain, I assume that before health insurance, patients had to bring cash to a hospital or doctor's office to cover all of the services up front. Insurance and hospitals give people financial credit even when they credit history indicates they have little chance of paying it back. 

Edited November 29, 2023 by Nice Guy Eddie

[BevoAbyss 2059]

2 hours ago, Disco Strangler said:

Somebody apparently thinks about the Roman Empire on a frequent basis.

Or ... it could be that UT gave me a fucking education!

Some great profs and smart students... learned so much.

Edited November 29, 2023 by BevoAbyss

[Nice Guy Eddie 13515]

8 minutes ago, BevoAbyss said:

Or ... it could be that UT gave me a fucking education!

Some great profs and smart students... learned so much.

For my liberal arts requirements, nothing beat the Classics dept. The class(es) on Rome is easily in my top 5 memorable classes at UT. Many of the classes in my major were forgetable.

 

[StassneyHorn 6616]

12 minutes ago, BevoAbyss said:

Or ... it could be that UT gave me a fucking education!

Some great profs and smart students... learned so much.

The real OG, can still hear his tic

[CooterBrown 18015]

1 hour ago, Nice Guy Eddie said:

I don't understand why medical debt is somehow viewed as a shortcoming of the system. Is it better than someone has debt for their boat but not have debt to save the life of their child? If it means I'm alive, take all of my money.

The issue is people have to choose if medical care is worth the cost.  The average American can't afford shit.  Going to ER, knowing you will get a bill pushing $2,000 even with insurance, causes many people to put it off.  This potentially makes it worse. When you've got 50 bucks to your name, that choice becomes more difficult.  It's easy to say "take my money" when you have money because you know can make more money.  For the working poor that mentality and ability doesn't exist.  Medical debt is something they can rarely, if ever, get out of.

 

[TwiceHorn 31496]

19 hours ago, Anastasis said:

Agree strongly wrt DTC advertising and I would go much further than most wrt restricting marketing activities. Agree that pharma pricing needs pressure applied. I think that the best approach is removing the various clouds and letting a competitive market shake it out, but there are certainly good arguments for leveraging government buying power in certain situations. We should also require health economic and cost effectiveness analyses as part of the approval process, in the same way the they do in UK and some european markets. It is part of a reasonable price finding process imo. Preventative care is a drop in the bucket and could/should be part of a revisioned Medicare backstop, jsut like it is with HDPs today,.   

Yep you had alluded to doing this (at least the efficacy part) in the patent system, which is ill equipped to do, as it is or would be everywhere. 

The FDA or a related agency is absolutely the place to do it. It is much closer to their existing remit. 

[TwiceHorn 31496]

4 hours ago, Nice Guy Eddie said:

You don't pay any more for care for similar emergency services at an out-of-network hospital. Now does every ER treat you the same? I'm sure some may order unnecessary tests but I don't believe for a second that most ER doctors are told to order unnecessary tests.

I don't understand why medical debt is somehow viewed as a shortcoming of the system. Is it better than someone has debt for their boat but not have debt to save the life of their child? If it means I'm alive, take all of my money.

While admittedly I don't know this for certain, I assume that before health insurance, patients had to bring cash to a hospital or doctor's office to cover all of the services up front. Insurance and hospitals give people financial credit even when they credit history indicates they have little chance of paying it back. 

Well, for one thing, medical debt is not negotiated in advance. 

If it was a matter of financing cancer treatment on agreed upon terms, that would be one thing. 

Medical debt more like losing a lawsuit.  You know there is some cost associated with your activity, but you have little idea what it really is and whether it survives a cost benefit analysis. 

Edited November 29, 2023 by TwiceHorn

[Nice Guy Eddie 13515]

47 minutes ago, CooterBrown said:

The issue is people have to choose if medical care is worth the cost.  The average American can't afford shit.  Going to ER, knowing you will get a bill pushing $2,000 even with insurance, causes many people to put it off.  This potentially makes it worse. When you've got 50 bucks to your name, that choice becomes more difficult.  It's easy to say "take my money" when you have money because you know can make more money.  For the working poor that mentality and ability doesn't exist.  Medical debt is something they can rarely, if ever, get out of.

 

My main ER experiences have been with my mom, who has a medicare advantage plan. I pay her bills, and even with ICU and regular hospital admits, she's received bills less than $500 for each ER-to-hospital stay. I was completely shocked that a 1-day ER and 3-day ICU totaled out of pocket $500. Did her insurance pay a lot more? 100% absolutely.

I don't mean this as a let them eat cake attitude, but if people walk around with either no health insurance or extremely bad insurance, they will eventually have medical debt. Especially in states like Texas that don't care. 

 

[Eskimohorn 5635]

Or ... it could be that UT gave me a fucking education!
Some great profs and smart students... learned so much.

Lighten up Francis. Thinking about the Roman Empire is a meme going around.

[Chewbacca 7780]

15 hours ago, fattyflattie said:

A little bit of heat and the inability to instant abort your one nighter doesn’t make a state shitty. Contrary to the whining on this board.  

You clearly don't know anyone who desperately wanted a pregnancy and had to abort it and it shows.  Learn a little compassion.  It goes a long way.

[Chewbacca 7780]

14 hours ago, elfenix said:

*claims to hate people on the dole, supports policies that demonstrably result in more people on the dole*

They only love unborn children.  Once they're born, they can fuck right off.

[safe sex 11735]

18 minutes ago, Nice Guy Eddie said:

I don't mean this as a let them eat cake attitude, but if people walk around with either no health insurance or extremely bad insurance, they will eventually have medical debt. Especially in states like Texas that don't care. 

 

It's almost like everyone should have access to the kinds of plan your mom is on. Some kind of...Medicare... for all? Does that sound right?

Edited November 29, 2023 by safe sex

[Post Oak 20246]

Food banks are being stretched thin.

 

“How long can we keep this up?” Food banks are under pressure from Texas’ high level of food insecurity

 

Inflation, stagnant federal funding for food programs and high housing costs mean that demand at food banks still hasn’t returned to pre-pandemic levels.

 

https://www.texastribune.org/2023/11/28/texas-food-banks-high-demand-snap/

 

[Anastasis 23475]

3 hours ago, Dutchrudder said:

Is any political party trying to actively address these issues and provide more healthcare to everyone? 

Let's go through some of the specific issues that I raised. 

DTC advertising - I am not aware of any current legislation being proposed, but haven't really searched. Happy to discuss the legislation if there is some to consider. Durbin did something last congress (with GOP cosponsors), but it was only about publishing pricing as part of the DTC, and died in the Senate. 

Expanded HSA access - Variety of legislation in play: https://www.govtrack.us/search?q=HSA 

Pharma pricing, competitive market - S1114, intended to speed generics to market (D primary sponsor, R cosponsor); S1067, limits citizen petitions that slow generic entry (D sponsor, 3R/2D cosponsors); S113, requires FTC to report anticompetitive practices (R sponsor, 10R/9D/1I cosponsors); others here: https://www.govtrack.us/congress/bills/subjects/prescription_drugs/6184 . None of these really get to a functional market, but fwiw. 

Pharma pricing, gov negotiations - IRA obviously, we get to see how that plays out and has been discussed on other threads. Not familiar with any other current relevant bills. 

Economic analyses as part of regulatory approval process - lol, no. 

 

If you want to discuss any particular legislative proposals, happy to engage, but we should probably move it over to one of the healthcare policy threads. 

Edited November 29, 2023 by Anastasis

[CooterBrown 18015]

31 minutes ago, Nice Guy Eddie said:

My main ER experiences have been with my mom, who has a medicare advantage plan. I pay her bills, and even with ICU and regular hospital admits, she's received bills less than $500 for each ER-to-hospital stay. I was completely shocked that a 1-day ER and 3-day ICU totaled out of pocket $500. Did her insurance pay a lot more? 100% absolutely.

I don't mean this as a let them eat cake attitude, but if people walk around with either no health insurance or extremely bad insurance, they will eventually have medical debt. Especially in states like Texas that don't care. 

 

It's totally a let them eat cake attitude.  You're applying a single example to the masses.

For example, I have the top PPO plan my Fortune 500 company offers and my ER bill a few months ago was $1,700 out of pocket for being there 3 hours.  It's literally the best insurance I can get. Due to a heart condition, I am uninsurable outside of a work group plan or  Obamacare.

That same plan refused to pay my $210,000 bill for stents 7 years ago because I should not have been admitted to the hospital for undetermined chest pains, the blockage should have never been discovered.  That's literally what the denial letter stated.  Luckily, their contract with Seton said the hospital had to eat any costs beyond my copay limits. 

The entire system is broken. 

 

 

[Nice Guy Eddie 13515]

12 minutes ago, CooterBrown said:

It's totally a let them eat cake attitude.  You're applying a single example to the masses.

For example, I have the top PPO plan my Fortune 500 company offers and my ER bill a few months ago was $1,700 out of pocket for being there 3 hours.  It's literally the best insurance I can get. Due to a heart condition, I am uninsurable outside of a work group plan or  Obamacare.

That same plan refused to pay my $210,000 bill for stents 7 years ago because I should not have been admitted to the hospital for undetermined chest pains, the blockage should have never been discovered.  That's literally what the denial letter stated.  Luckily, their contract with Seton said the hospital had to eat any costs beyond my copay limits. 

The entire system is broken. 

 

 

You didn’t have a 210k bill that required your payment. You only had to cover your copay so why mention the $210k?

[texasdago 7575]

36 minutes ago, Nice Guy Eddie said:

You didn’t have a 210k bill that required your payment. You only had to cover your copay so why mention the $210k?

Do you not see how ridiculous all of that is, though?  "uh, well you didn't have to pay it!?"  Well F it dude this is all crazy.  Our system is so broken.  I swear the rest of the world does something else and we keep wallowing in a pile of shit and saying, "but ours tastes soooo good!!?" WTF.

[CooterBrown 18015]

You didn’t have a 210k bill that required your payment. You only had to cover your copay so why mention the $210k?

If I’d chosen to go to a different hospital with a different contract with UnitedHealthcare, I could’ve been on the hook for a portion or all of that $210K. It came down to luck I went to the right hospital. Healthcare costs shouldn’t come down to luck.

[texasdago 7575]

4 minutes ago, CooterBrown said:

If I’d chosen to go to a different hospital with a different contract with UnitedHealthcare, I could’ve been on the hook for a portion or all of that $210K. It came down to luck I went to the right hospital. Healthcare costs shouldn’t come down to luck.

Healthcare decisions should not come down to this.  Since DalTxWhatever doesn't want to answer my question, let me give you a simple example...

As men (women, too) there comes an age when you need to get a lovely colonoscopy.  Good times.

So, many of us go through the process... how much does that cost?  What about anesthesia?  How much do I have to cough up?

You make decisions based on the cost, not on the health factor... I'm not alone as a lot of people go through this.  Yes, a colonoscopy can catch issues that can save you from bigger problems or can save your life.

BUT

I waited.  I took my time because it could be an extra $3K or so that I could spend elsewhere or on other needs or whatever.

Come to find out Obamacare covers it.  Nothing out of pocket.  Yup, the ACA covers the cost.  And guess what, you bet your ass (no pun intended) that every Republican voter out there crying about Obamacare is lining is "happy" getting their free colonoscopy. Or not.  I suppose they could pay for it to own the libs 'cause socialism.

The Affordable Care Act (ACA) mandates that private insurers and Medicare cover the costs of colorectal cancer screening tests since the United States Preventive Services Task Force (USPSTF) advises them. The ACA specifies that insurers do not charge people out-of-pocket costs, such as copays or deductibles, for those tests.8

 

[royiv 9326]

4 hours ago, Nice Guy Eddie said:

You didn’t have a 210k bill that required your payment. You only had to cover your copay so why mention the $210k?

Do you think Seton just smiles and moves along when they don't get paid on a high-end cardiac procedure? No, they factor that into their negotiations with the payers down the line and rates go up. Who pays for that? All of us do in the form of increased premiums. There's not some magic pot of money from the sky that keeps hospitals solvent. All of us pay to keep the doors open with our ever increasing premiums.

[TwiceHorn 31496]

3 hours ago, texasdago said:

Healthcare decisions should not come down to this.  Since DalTxWhatever doesn't want to answer my question, let me give you a simple example...

As men (women, too) there comes an age when you need to get a lovely colonoscopy.  Good times.

So, many of us go through the process... how much does that cost?  What about anesthesia?  How much do I have to cough up?

You make decisions based on the cost, not on the health factor... I'm not alone as a lot of people go through this.  Yes, a colonoscopy can catch issues that can save you from bigger problems or can save your life.

BUT

I waited.  I took my time because it could be an extra $3K or so that I could spend elsewhere or on other needs or whatever.

Come to find out Obamacare covers it.  Nothing out of pocket.  Yup, the ACA covers the cost.  And guess what, you bet your ass (no pun intended) that every Republican voter out there crying about Obamacare is lining is "happy" getting their free colonoscopy. Or not.  I suppose they could pay for it to own the libs 'cause socialism.

The Affordable Care Act (ACA) mandates that private insurers and Medicare cover the costs of colorectal cancer screening tests since the United States Preventive Services Task Force (USPSTF) advises them. The ACA specifies that insurers do not charge people out-of-pocket costs, such as copays or deductibles, for those tests.8

 

I railed against Obamacare at first.  But, it provides some pretty sensible things.  

[Al Bundy's Napoleon Hand 13585]

13 minutes ago, TwiceHorn said:

I railed against Obamacare at first.  But, it provides some pretty sensible things.  

Dems should have retained the public option when negotiating ObamneyCare since caving on that netted them absolutely nothing in GOP support. 

[Hornius Emeritus 12471]

33 minutes ago, TwiceHorn said:

I railed against Obamacare at first.  But, it provides some pretty sensible things.  

You've got mail. 😀

[Anastasis 23475]

52 minutes ago, Al Bundy's Napoleon Hand said:

Dems should have retained the public option when negotiating ObamneyCare since caving on that netted them absolutely nothing in GOP support. 

That was Lieberman’s doing.