Obamacare, or, I might be up a creek w/o a paddle

[frugalone]

I never paid much attention to the whole Affordable Health Care thing, because we have an "OK" plan through BC/BS that is kind of bare-bones, but has been alright so far. My employer offers insurance, but it would be a real stretch to be able to afford it.

Well, yesterday we got a letter from BC/BS with the bad news: They are dropping our special program. And there are five brochures full of info about their "new plans"--with outrageous prices (funnily enough, they are only listing prices for individuals, not couples or families) and ridiculous deductibles. I realize we need to talk directly to our insurer to get a clear picture, but I am having a very rough time trying not to flip out/panic over this. Financially, I just can't take another hit. As I said in another thread, what good does tax credit do if you can't pay the premiums in the first place?

I also realize this is a giant piece of propaganda. I mean, our government is threatening to shut down over this whole Obamacare thing. And also, could there be better plans out there? Won't the insurance companies all be competing for business? Shouldn't this bring the cost of insurance down?

Am I the only one who feels this way? Maybe I'm getting the wrong picture here...but I thought the whole point was Affordable Health Care! Not sock it to the already working poor.

Sorry for the little rant. It's just been very rough for me lately.

[Alan]

The problem is, the Affordable Care Act doesn't allow 'bare bones' coverage. It sets a minimum standard which everyone must purchase in order to spread the costs around. A perfect example of the old adage, "be careful what you wish for".

[frugalone]

Alan, I didn't know that. I thought the idea was just to provide everyone with SOME sort of coverage, rather than having a large amount of uninsured. I seem to fall somewhere in the middle. Our household income is too high for us to get any kind of public "relief" and it's too low for me to comfortably afford the premiums. I'm lucky that my employer does offer some sort of insurance. But it's quite clear from the large leap in price that I can see on the forms at work that they do NOT want to pay for family members. They're more than happy to just cover the employee--but add a family member (or two or three) and the price skyrockets.

[redfox]

And the perfect argument for universal coverage & single payer. I too am facing a hefty premium increase, and got some details from my insurer (I am currently private pay). There are 10 required to cover items, including maternity and pediatric dental & vision. I don't need either! But I do understand the necessity under this design to create a huge pool to spread costs around, as Alan said. It is a very conservative, Republican plan, which preserves the huge profits for insurance companies at the expense of individuals. I am glad that coverage cannot be denied for pre-existing conditions. Health care needs to be taken out of the for-profit commodities market -- there are many things appropriate to this market, but not basic human needs.

I have hopefully solved my dilemma as a private pay individual. I have a job offer on the table, which I'll finalize tomorrow. It is at less than half my usual salary, but comes with good health insurance with my current providers, which, if one has been in treatment for cancer & finds good providers, is immeasurably valuable. I am taking the position for the health insurance... and the promise that after Jan. 1, the job will change upwards with a concomitant pay increase.

[frugalone]

Wow, this is more complicated than I thought. If it's a conservative plan, why are the Republicans arguing against it? It's not "socialistic" at all.
And I use those terms loosely, of course.

[ApatheticNoMore]

The bare bones plans were never that great to begin with IMO. The majority of people filing for medical bankruptcy have insurance, wonder how much bare bones plans have to do with that.

But anyway, Obamacare, not a fan, but just to give actual advice: as I understand it you can go on the exchange(s) and look at the prices that other insurance companies are charging, plus unless your income is too high, you probably qualify for a subsidy to purchase that insurance. Yes, you're probably better off if you happen to be in a blue state as they are kind trying to make this work. But in short: do the research to make sure you fully understand what your options actually are, part of Obamacare was hiring people to help people navigate it (yea I know why do we have people to help people navigate the Obamacare maze rather than Medicare for all, that everyone could understand easily - don't ask me - I'm just saying how to make the best use you can of the system, such as it is, even if it's not a good system). And yea you may find your employer provided insurance is the best bet, it often is if they're picking up some of the cost. I don't actually know if you can get both the employer subsidy and an Obamacare subsidy at the same time.


I also realize this is a giant piece of propaganda. I mean, our government is threatening to shut down over this whole Obamacare thing.

Could be. Maybe blue cross wasn't one of the insurance companies in on the Obamacare discussions (insurance companies were definitely part of the drafting of Obamacare), or even if they were, honor among theives you know. :)


And also, could there be better plans out there? Won't the insurance companies all be competing for business? Shouldn't this bring the cost of insurance down?

I dont' know, it's kinda doubtful private insurance can work at all, or the at least on the for profit model (plus with our ridiculously inflated hospitalization and pharma costs).


Am I the only one who feels this way? Maybe I'm getting the wrong picture here...but I thought the whole point was Affordable Health Care! Not sock it to the already working poor.

there seems to be people it benefits and people it hurts (and many people whom it probably doesn't affect much one way or other). It definitely hurts people who say had really good union plans. Those are no more, and those were really enviable plans that actually got the whole healthcare thing right, probably in one of the few ways it could be gotten right short of socialized medicine. But most people weren't one of those lucky ones.

[redfox]

Wow, this is more complicated than I thought. If it's a conservative plan, why are the Republicans arguing against it? It's not "socialistic" at all.
And I use those terms loosely, of course.

Well, what a good question! Since it was modeled on Romney's plan, the GOP nominee, it doesn't seem to be about the plan itself. I am beginning to suspect it's simply because That Black Dude in the White House put it forth. It is definitely not "socialistic"! (One of the sillier words to come about lately, too.)

[ApatheticNoMore]

I thought the idea was just to provide everyone with SOME sort of coverage, rather than having a large amount of uninsured.

The projections for Obamacare are and pretty much always have been: there will still be uninsured, but the number of uninsured is predicted to be less than it would be otherwise. The uninsured are not going away though. In addition many people will be under-insured (insured but with junky policies).


I seem to fall somewhere in the middle. Our household income is too high for us to get any kind of public "relief" and it's too low for me to comfortably afford the premiums. I'm lucky that my employer does offer some sort of insurance.

The income to qualify for some kind of subsidy goes pretty high in most parts of the country (it doesn't work out so favorably in high cost of living areas of course).

"Anyone earning up to 400% of the poverty line will be eligible for a subsidy, which is up to $45,960 for an individual and $94,200 for a family of four."

But yea earning 50k in say California would not make one rich, and if one was also older the full cost of premiums could run over 1k a month. In that situation it might not be a bad decision if one earned too much to get a job paying just under the subsidy limit so at least your premium would be capped at some $300 a month, rather than having no caps at all.


But it's quite clear from the large leap in price that I can see on the forms at work that they do NOT want to pay for family members. They're more than happy to just cover the employee--but add a family member (or two or three) and the price skyrockets.

oh yea that's always been what I've seen from employer provided insurance pricing. And I'm always just: ok how does anyone actually afford to live with kids (and especially with a non-working spouse). Haha, if that was me, I'd me I'd tell the spouse: get a job with health insurance or get out of the house! And then I'd tell the kids the same thing! Ok I'm kidding about the kids :). But while it's obvious to me how I can afford to live as a single, it's not clear to me how anyone can afford their health insurance paying for a whole family.


Wow, this is more complicated than I thought. If it's a conservative plan, why are the Republicans arguing against it? It's not "socialistic" at all.
And I use those terms loosely, of course.

Isn't it the Heritage center (conservative think tank) plan originally? It's also Romneycare. They're playing politics.

[Simpler at Fifty]

The problem is, the Affordable Care Act doesn't allow 'bare bones' coverage. It sets a minimum standard which everyone must purchase in order to spread the costs around. A perfect example of the old adage, "be careful what you wish for".

+1000

[frugalone]

Been doing some reading online.
Yeah, I think we're screwed in my household.

I see how this works. As long as my (and that's MY) coverage isn't more than 9.5% of my salary, then that's supposedly cool. However, when you add in my spouse, that makes it unaffordable.

Yeah, I do wonder how people with kids manage to pay for it. Even WITH a working spouse, it's still tough.

[Alan]

Well, what a good question! Since it was modeled on Romney's plan, the GOP nominee, it doesn't seem to be about the plan itself. I am beginning to suspect it's simply because That Black Dude in the White House put it forth. It is definitely not "socialistic"! (One of the sillier words to come about lately, too.)

LOL, I'm sorry but I find this extremely amusing. It is fairly socialistic and the Mass legislature over-rode Romney's veto of the 8 or 10 most intrusive elements of the legislation which eventually became known as Romneycare.

And, the 'Black Dude in the White House' narrative is simply precious.

[iris lilies]

I remember when a couple of posters here from the state of Mass. talked about their state required insurance. I found that interesting, and I remember when one of them complained about having to drop his/her high deducible plan to take a plan that covered all of the requirement of the state. That was the harbinger of this requirement in ObamaCare, so I wasn't surprised when this issue came forward in recent months.

I found the Mass. experiment to be interesting and useful to watch from afar, but I thought it was too bad that high deductibles plans are out the window since I think that the average American needs to plan for and pay for routine medical care. In my mind it's just bad philosophy to expect insurance to pay for it all.

That said, ObamaCare does allow for 4 levels of insurance (bronze, silver, gold and platinum (?) so there remains some level of choice in the deal.

Remember that birth control pills must be covered. Even if one would prefer to pay for them yourself and have a high deductible, that choice is not yours to make.

[iris lilies]

Well, what a good question! Since it was modeled on Romney's plan, the GOP nominee, it doesn't seem to be about the plan itself. I am beginning to suspect it's simply because That Black Dude in the White House put it forth. It is definitely not "socialistic"! (One of the sillier words to come about lately, too.)

If you guys want to toss around labels, ok whatever. I don't see the point, but go for it.

It is obvious to me that any government mandated endeavor to make everyone play in the same health sandbox is a socialist concept. But since I don't much care about labels, you can win the point if you like. I am kind like that. :) It's the substance of the legislation that irks me.

edited to add:
http://dictionary.reference.com/browse/socialist

shows that the word was not invented last week by the Tea Partiers as redfox implies, but instead, is an adjective that's been around as long as the concept of socialism.

[frugalone]

Please, let's not turn this thread into an argument about the two houses or Obama or anything like that.
I'm sitting here having a hard time breathing and keeping my head because of this.
Like, on the verge of a panic attack.
I didn't mean to incite a riot.

[ApatheticNoMore]

Nah, it's not socialist, SOCIALIST not socialistic, by any measure I'd use -mostly who owns the means of production right.

so·cial·ism
noun
1.a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole.
2.procedure or practice in accordance with this theory.
3. in Marxist theory) the stage following capitalism in the transition of a society to communism, characterized by the imperfect implementation of collectivist principles. (yea you can have fun with the vagueness of this description but unless you really want to start citing arguments from Marx's writings about socialism and I can't claim to be an expert on that, you are probably NOT adequately arguing it's socialism based on this definition).

So what part of private insurance companies, private hospitals, private pharma companies with capitalist shareholders is socialist? Now it may be a plenty crony kind of capitalism (which seems quite common in capitalism, fancy that, in fact much of the economic system except for some small businesses these days seems pretty crony to me) but .... not socialist. While socialized medicine in some cases may actually be socialist (the British model) private insurance companies are not.

[iris lilies]

ANM, that fact that citizens are required by Nanny G to use the private businesses, the fact that the private business MUST serve all, and the fact the tax money is funding part of this mandate, those are the socialist(ic) parts.

It's a gory mix of capitalism, socialism, and stupidityism, that's for sure.

[ApatheticNoMore]

Please, let's not turn this thread into an argument about the two houses or Obama or anything like that.
I'm sitting here having a hard time breathing and keeping my head because of this.
Like, on the verge of a panic attack.
I didn't mean to incite a riot.

You really do need to do further research to make sure you are aware of all your options. Mind you it's not easy to do more research if there is a possibility there may be no good solution anyway (pretty much how I feel about Fukushima). And I never promised you an Obama pony :laff: I've warned people that guy isn't all he seems. But if Obamacare has supposedly hired people who are supposed to help people navigate Obamacare ...

But vent if need be, vent about the horror of the worst case scenario and how frustrating Obamacare is (it's difficulty to understand is not the least of it's frustrations! plus losing a healthcare plan you at least kind of understood), but eventually maybe talk to people who are knowledgeable on the ins and outs of Obamacare just in case there might be a good (or maybe at least not terrible, maybe that's the best we can expect :)) option for you.

I got a long Obamacare pdf from HR that I haven't even read, mostly because I don't think Obamacare will affect employer provided insurance (except that prices will keep going up probably just like they did before Obamacare and this is not good!), but if it does change my employer provided coverage, then I guess that wouldn't be good.

[iris lilies]

I will add a random observation today, the day that Breaking Bad airs its final episode. I don't want to de-rail the Breaking Bad thread with Obama politics.

But it amuses me that the pseudo-reason cooked up by BB Hollywood writers for Walter White to go into the meth business is that he couldn't afford the cancer treatments recommended by his doctor. And then, a few seasons later, same thing for his brother in law Hank.

These guys are both public employees who have the best health insurance available. This is teevee B.S. and as such is unbelievable.

But I can suspend disbelief with the best of them because Breaking Bad is a fine piece of entertainment.

[try2bfrugal]

Are you guys with private pay or unaffordable employer insurance looking at your state's health insurance exchanges for premium rates? Do you know what your subsidy amounts will be? I am having a hard time believing with some of the household incomes posted frequently on this forum that many of you will not get highly subsidized plans.

Look at your state exchanges or use the Kaiser calculator and see what rates you will be paying. For a family of four there are significant subsidies for households making up to 400% of poverty level which is over $90K.

The Kaiser estimator is here -
http://kff.org/interactive/subsidy-calculator/

And you do not have to wait until you file your tax returns to get the subsidy credits.

In my state and zip code, 2 people aged 35 with a $35K modified adjusted gross income could get a Bronze policy for $33 a month.

[try2bfrugal]

Iris Lilies - The teachers in our public school district do not have employer health insurance, even those teaching at schools in the affluent (> $100K household income) zip codes.

Here is a UK version of Breaking Bad -

http://www.buzzfeed.com/lukelewis/if-breaking-bad-had-been-set-in-the-uk

[frugalone]

I believe I am in the 200% range. However, the language reads "and you would have to pay more than 9.5% of your household income for your own coverage through the insurance offered by your employer." It wouldn't be more than 9.5% for MY coverage, but add in other family members and it becomes very high.

I am wondering how the government hopes this plan will cover non-working spouses. Or non-working partners in homosexual couples who live in states that do not currently have legal marriage for same-sex couples.

Or how about people who are unemployed and have no income? My COBRA ran out and my UC benefits did too. That's how I got on the bare-bones program. We didn't qualify for public health insurance, either.

[frugalone]

Hi--do you mind if I ask which state you are in?
How much are the deductibles for that Bronze plan. Just curious. Thanks!



In my state and zip code, 2 people aged 35 with a $35K modified adjusted gross income could get a Bronze policy for $33 a month.

[try2bfrugal]

Or how about people who are unemployed and have no income?

They would get free health care under Medicaid for states that have this option in place.

Here is a state by state list of where that stands -

http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/

[try2bfrugal]

I am in California. You can look up the deductibles on the Covered California exchange site. But if you live somewhere else it doesn't matter what the California rates are unless you are planning a move. Deductibles are highest on the Bronze plans, but if you are healthy and a low consumer of medical care, they might be your optimal option.

You might still be able to get exchange rates if "..your employer will offer family coverage, however, your family's eligibility for subsidized coverage on the exchanges will depend on whether your job-based coverage is considered unaffordable or inadequate under the law. If the cost for single coverage is more than 9.5 percent of your income or the policy doesn't cover at least 60 percent of your allowed medical costs, your whole family could be eligible for subsidized coverage on the exchange.

http://www.kaiserhealthnews.org/features/insuring-your-health/2013/043013-michelle-andrews-readers-questions-on-exchange.aspx

You can call and ask the exchange advisers after October 1st and see if there is anything they can do for you based on your current employer coverage options.

[jp1]

I believe I am in the 200% range. However, the language reads "and you would have to pay more than 9.5% of your household income for your own coverage through the insurance offered by your employer." It wouldn't be more than 9.5% for MY coverage, but add in other family members and it becomes very high.

I am wondering how the government hopes this plan will cover non-working spouses. Or non-working partners in homosexual couples who live in states that do not currently have legal marriage for same-sex couples.

Or how about people who are unemployed and have no income? My COBRA ran out and my UC benefits did too. That's how I got on the bare-bones program. We didn't qualify for public health insurance, either.

Frugal, unfortunately I think I heard somewhere/read somewhere that your situation is an unintended flaw in the way the law was written. The intention was for it to be 9.5% of total household income to cover the whole household, but it ended up being for the individual, even though that individual is financially responsible for the rest of the household.

As for homosexual (or heterosexual) non-married domestic partners I would assume that the non-working one would be able to qualify for subsidies based on their own income or lack thereof.

[try2bfrugal]

Frugal, unfortunately I think I heard somewhere/read somewhere that your situation is an unintended flaw in the way the law was written. The intention was for it to be 9.5% of total household income to cover the whole household, but it ended up being for the individual, even though that individual is financially responsible for the rest of the household.

As for homosexual (or heterosexual) non-married domestic partners I would assume that the non-working one would be able to qualify for subsidies based on their own income or lack thereof.

Yes, I see that written up here -

http://www.usatoday.com/story/news/politics/2013/09/23/aca-family-glitch-issues/2804017/

It was a wording error in the law that has not been fixed to date.

[frugalone]

for more fun and games, go on over to my thread in Workplace called "raises" and read about how my small raise will most likely put me outside the federal poverty level and other complications.

I'm really, really trying not to freak out about this...since I can't get any solid info till Oct. anyway.

Looks like that USA Today article is accurate.

[try2bfrugal]

for more fun and games, go on over to my thread in Workplace called "raises" and read about how my small raise will most likely put me outside the federal poverty level and other complications.

I'm really, really trying not to freak out about this...since I can't get any solid info till Oct. anyway.

Looks like that USA Today article is accurate.

The ACA is based on modified adjusted gross income (MAGI), not gross income, so it may be possible to reduce your MAGI by making a 401K or IRA deduction, if that ends up helping.

Sorry to hear about your situation, frugalone. I did not know about the wording glitch until this thread.

[frugalone]

I'm thinking I might need to see an accountant. Currently, I don't make any retirement contributions--because I can't really afford to.

[bae]

Another fun unintended consequence:

I am in the middle of hiring an employee for a governmental organization. While the organization has the same powers and authority as an incorporated city, it is a quite small organization - one minion (already hired) and one manager (the new hire) to replace a retiring employee.

This small of a governmental entity, for a variety of reasons, cannot participate in the state employees' health program, which is quite good. Our normal practice to date has been to cover "90% of the cost of whatever health insurance you can find that is roughly similar in coverage to the state program".

We cannot make an intelligible offer to any of our candidates - they ask what the health coverage is, and we have no clarity on what we can provide them at present.

So this makes it very difficult to hire anyone, even though we have a position available, and interested candidates. And it would be "bad" to not fill this position, as it is the manager of a commercial service airport...

[gimmethesimplelife]

Something I am learning about ObamaCare - not everyone shares my economic reality. This has been a hard pill to swallow, it really has. Coming from an economically challenged background to put it nicely, I see the ACA as a miracle. The fact that I am going to qualify for expanded Medicaid is just unbelievable to me. It really is and given that I would have health care automatically in any other developed country, to me it is both reality that is long overdue and it is a real trial to find forgiveness for America that until very recently, human life has not been worth something like the ACA. This is my reality - I really don't know how to forgive America for this.

BUT OTOH, not everyone shares my reality. I wonder if I had experienced more economic stability in my life, and if I had had insurance coverage non-stop, would I see things differently? I'm guessing I very well might. I believe my take on ObamaCare given my background is valid - but why should the takes of those who have lived much more stable lives and have not know the fear of not having insurance be any less valid? Like so many other things, I am seeing this as a social class issue.

Even more interesting - my goal is to make enough money to move off of Medicaid and get onto the exchages as self employed person. Two things here that strike me - I am so so so very grateful that via ObamaCare insurance is starting to de-link even more from the workplace.....and that I can get onto a policy with pre-existing conditions. To me this is indeed miraculous. OTOH, I see some unpleasant deductible numbers which makes me realize that my days of going to Mexico for health care are not over. ObamaCare for me is going to be a sleep better at night kind of thing but I still will be comparing costs to Mexico - once I move off of Medicaid, which I don't care to stay on for a long period of time, as I want my income to increase.

So my big shocker here is that I understand not everyone shares my reality as not everyone shares my economic background.....Very interesting. To those who don't share it with me, all I can do is ask that you understand that not everyone shares your economic background and therefore there are those who are going to view ObamaCare very differently. Rob

[iris lilies]

...Like so many other things, I am seeing this as a social class issue...

And I see this as a "choices we've made" issue.

For sure we are going to view this and many things differently.

[Tradd]

Gee, Rob, tell that to part-time Trader Joes employees who have now lost their employer-provided health insurance.

http://swampland.time.com/2013/09/17/trader-joes-explains-why-its-cutting-health-benefits-for-part-timers/

Or those who buy private insurance who are now facing much higher rates because of Obamacare.

I know many people who originally thought Obamacare was a good thing. But due to the "unintended consequences," they are now, to put it bluntly, screwed.

It's affecting the finances of one couple so badly, they are investigating going to the husband's home country (UK) and the wife renouncing her American citizenship. I have no details about their situation, other than what's in the previous sentence.

[gimmethesimplelife]

Gee, Rob, tell that to part-time Trader Joes employees who have now lost their employer-provided health insurance.

http://swampland.time.com/2013/09/17/trader-joes-explains-why-its-cutting-health-benefits-for-part-timers/

Or those who buy private insurance who are now facing much higher rates because of Obamacare.

I know many people who originally thought Obamacare was a good thing. But due to the "unintended consequences," they are now, to put it bluntly, screwed.

It's affecting the finances of one couple so badly, they are investigating going to the husband's home country (UK) and the wife renouncing her American citizenship. I have no details about their situation, other than what's in the previous sentence.Tradd, correct me if I am wrong.....I understand that in the Trader Joes instance, the workers are being pushed onto the health care exchanges, and since they are PT, they are more than likely going to get heavy subsidation, so what the actually pay for premiums is not going to be all that bad. They are also getting a one time check of $500 from Trader Joes to help with premiums. If they end out paying something like $78 a month, that $500 will go a long way in covering them. I would not be at all surprised to see more companies doing this and I for one embrace this as it means not having health insurance linked to employment. Just think! This means that you need you employer a little less if you have some savings! To me this is incredible.....but then the American work ethic, work above most all else, has never worked for me either, so it's only natural I'd want insurance to be separate from work. Rob

[gimmethesimplelife]

Tradd. also I forgot to mention, in the case of the married couple debating moving to England and the wife giving up her US citizenship - how ironic that the UK has socialized medicine. They would be moving to a place with socialized medicine due to changes in US laws trying to get more of the population covered! What bitter irony this must be for them if they have realized it/seen it. Rob

[bae]

Or those who buy private insurance who are now facing much higher rates because of Obamacare.


I pay for my family's own, minimal, catastrophic coverage out-of-pocket.

Shortly after Obamacare was passed into law, my rates went through the roof, seemingly because they raised them the maximum they could get away with, and at every opportunity after that. Presumably to establish a nice solid baseline before the law went into effect.

[try2bfrugal]

Gee, Rob, tell that to part-time Trader Joes employees who have now lost their employer-provided health insurance.

http://swampland.time.com/2013/09/17/trader-joes-explains-why-its-cutting-health-benefits-for-part-timers/


If frugalone's employer stopped offering insurance like Trader Joe's did, she could get a better deal on the exchanges. Trader Joe's did their part time employees a favor by not offering them health insurance any more. Now most can get better, highly subsidized insurance on the exchanges, instead of the inferior policy that was the best TJ's could offer.

[try2bfrugal]

It's affecting the finances of one couple so badly, they are investigating going to the husband's home country (UK) and the wife renouncing her American citizenship. I have no details about their situation, other than what's in the previous sentence.

If you have no idea about their situation, then what is your point, other than they are better off moving to a country with universal health care?

[Alan]

To me this is incredible.....but then the American work ethic, work above most all else, has never worked for me either, so it's only natural I'd want insurance to be separate from work. Rob
And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

[ApatheticNoMore]

More employees going part time is not a good idea unless they have the hourly rate to support themselves on that. Sure people that bring in money might be ok with going part time, because they can afford it.


..Like so many other things, I am seeing this as a social class issue...


And I see this as a "choices we've made" issue.

For many people it's not a choice, someone growing up in the ghetto to a crackhead mom probably never had a chance anyway (and the worst of them don't end up complaining about healthcare, but end up behind bars - where hey they do have full healthcare - yea we better all envy them >8)). There's very little that is a choice as life progresses quickly and most decisions that actually matter are made very early on (long before you've worked out the damage of your upbringing). The only ones that genuinely annoy me are those who deliberately chose lower paying jobs than they could get and then want to complain about it. Basically people who had advantages and deliberately throw them away and then complain. The advance degree set are especially ridiculous since I've always did whatever I had to survive in this world without that stuff (though I do realize it is harder for young people these days, so I'll cut a certain handicap for being a 20 something :)).

The thing is absolutely noone would care about these issues at all with regard to medical care if there was good Medicare for all that they knew they qualified by merely by being a citizen, because then they'd be benefiting too, but hey if you have to create a system written by the insurance companies with weird subsidies that creates winners and losers (almost randomly), what do you expect really.

[gimmethesimplelife]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?Here you have very concisely nailed why so much of America does not work for me - to me, it's not your tab, its OUR tab - our being the collective society as a whole. But I do agree with you on one point - people getting the free insurance like I will be for awhile should have some mandate to eat better and to exerisize. In my case I am mostly vegetarian and I don't have a car - so I am getting a lot of walking in right there. I am aware that not all who qualify for expanded Medicaid are going to be eating well and getting exersize so I do see you have a point in this. I still consider it OUR tab though and not just your tab. This kind of thinking - I believe this is what is going to cause America to sink ever further. And it's sad because most people have thought this way their whole lives - it is unrealistic for this to change. I'm glad change is coming to health care but OTOH I don't have much hope for this country in other areas. The bitter irony in this though is that I have seen what I consider progress in health care and also in gay rights. Rob

[Miss Cellane]

We were talking about this at work. "We" being a bunch of contract workers and temps, none with employer provided insurance. One woman said she'd be fine--based on her income and the fact that she is a cancer survivor, her local hospital provides her with free health care. I hated to be the one to explain to her that she is free to avoid getting health insurance under the new plan, but the way I read our state's web pages on the matter, she'll be fined and she will have to pay for all her health care.

I think I shocked her into at least doing a little research on the matter--I think that she thought she was okay and didn't have to worry about this. But my guess is that the money that used to pay for her "free" health care will now be funneled into the new insurance programs.

[gimmethesimplelife]

If you have no idea about their situation, then what is your point, other than they are better off moving to a country with universal health care?+1 Rob

[bae]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

Alan - I thought you'd like to know, I've decided to be a poet and philosopher for the next 20 years, this whole "work work work" thing is just too old-school for me in this progressive era. So if it helps you feel better, I'll be putting your dollars to good use!

[bae]

Here you have very concisely nailed why so much of America does not work for me - to me, it's not your tab, its OUR tab - our being the collective society as a whole.

How nice that must be!

In a higher phase of progressive society, after the enslaving subordination of the individual to the division of labor, and therewith also the antithesis between mental and physical labor, has vanished; after labor has become not only a means of life but life's prime want; after the productive forces have also increased with the all-around development of the individual, and all the springs of co-operative wealth flow more abundantly—only then can the narrow horizon of bourgeois right be crossed in its entirety and society inscribe on its banners: From each according to his ability, to each according to his needs!

[gimmethesimplelife]

And I see this as a "choices we've made" issue.

For sure we are going to view this and many things differently. +1 I really respect you for understanding this.....many don't. Rob

[gimmethesimplelife]

How nice that must be!

In a higher phase of progressive society, after the enslaving subordination of the individual to the division of labor, and therewith also the antithesis between mental and physical labor, has vanished; after labor has become not only a means of life but life's prime want; after the productive forces have also increased with the all-around development of the individual, and all the springs of co-operative wealth flow more abundantly—only then can the narrow horizon of bourgeois right be crossed in its entirety and society inscribe on its banners: From each according to his ability, to each according to his needs!Pretty much this kind of thinking that I am exhibiting here - this is very European kind of thinking and to a lesser degree Australian and New Zealand thinking - these countries have more of a "we" than a "me" mentality going on. I was about 12 wnen I decided for me personally it was going to be more "we" and not so much "me" - at least as far as basic human rights issues such as access to health care go. Rob

[iris lilies]

I pay for my family's own, minimal, catastrophic coverage out-of-pocket.

Shortly after Obamacare was passed into law, my rates went through the roof, seemingly because they raised them the maximum they could get away with, and at every opportunity after that. Presumably to establish a nice solid baseline before the law went into effect.

You won't get by with that catastrophic policy now, buddy.

[gimmethesimplelife]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?Just wanted to add - I have not been a freeloader on the system. I have had several months of unemployment insurance, five months on Medicaid, and five months of food stamps. Other than that I have been self supporting. When I talk of the American work ethic I speak of putting work before all else in life. I am willing to work but work has very little to do with where I take satisfaction in life, or where I draw identity from. Work to me is a source of income to pay bills and hopefully save money with - nothing more, nothing less. It has importance in my life, yes, but it is not the most important aspect of my life in any way. This is what I was getting at by mentioning the American work ethic. Rob

[ApatheticNoMore]

yea that's how just about everyone views work, as a means to pay the bills, few and far between indeed are those who view it otherwise. People at my office are deeply unhappy on mondays and complain a lot and thrilled for fridays.

[iris lilies]

... The only ones that genuinely annoy me are those who deliberately chose lower paying jobs than they could get and then want to complain about it. ....

why thanks for voicing my very thought.

Now, don't misunderstand me. I think it is a perfectly fine life choice to NOT chase a corporate career in all versions. Believe it or not, I admire alternative lifestyle choices. But when those players
1) play the victim
2) require a unusual amount of public subsidy for that lifestyle

don't expect me to celebrate it.

[gimmethesimplelife]

why thanks for voicing my very thought.

Now, don't misunderstand me. I think it is a perfectly fine life choice to NOT chase a corporate career in all versions. Believe it or not, I admire alternative lifestyle choices. But when those players
1) play the victim
2) require a unusual amount of public subsidy for that lifestyle

don't expect me to celebrate it.I can accept what you have posted here, IL. My point is this - with the opportunities for so many folks limited these days due to outsourcing, globalization, automation, etc. and those who still retain good jobs being expected to constantly produce more and more and more - this forces people into either the role of victim or to place work above all else. True, some may find some relief in self employment, but not all are cut out to be their own boss. I guess what I am saying is that while I don't disagree with you, the system seems to me anyway to work in such a way that you are cast into one of these two roles - victim to some degree, though some do escape this, and B. Work and nothing else matters.

I don't expect you to celebrate this as you have said, I sure don't either. Rob

[iris lilies]

I can accept what you have posted here, IL. My point is this - with the opportunities for so many folks limited these days due to outsourcing, globalization, automation, etc. and those who still retain good jobs being expected to constantly produce more and more and more - this forces people into either the role of victim or to place work above all else. True, some may find some relief in self employment, but not all are cut out to be their own boss. I guess what I am saying is that while I don't disagree with you, the system seems to me anyway to work in such a way that you are cast into one of these two roles - victim to some degree, though some do escape this, and B. Work and nothing else matters.

I don't expect you to celebrate this as you have said, I sure don't either. Rob

Ok, I accept it! :)

[bae]

You won't get by with that catastrophic policy now, buddy.

Nope. My wife, who used to practice insurance law, has been unable to untangle what insurance will be available in Washington State, and how we buy it. My county has been invaded by a legion of tax-dollar-paid worker bees who will be explaining this all to us in a series of public meetings and training seminars. I know several of the "facilitators" who were hired for this program, and they have no experience in the field other than whatever minimal training they received before being let loose upon us.

[reader99]

They would get free health care under Medicaid for states that have this option in place.
e
Here is a state by state list of where that stands -

http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/ Sadly, in FL it's not just income. My income is aboiut $500 a month but I have aqssets greate than $2,000 so I was turned down for Medicaid. For the foreseeable future I'll continue to not have access to jhealth care.

[try2bfrugal]

Sadly, in FL it's not just income. My income is aboiut $500 a month but I have aqssets greate than $2,000 so I was turned down for Medicaid. For the foreseeable future I'll continue to not have access to jhealth care.

If you moved to a state that did expand Medicaid under the ACA you would qualify. They did away with the asset test. Or if Florida expanded the ACA you could get Medicaid. The Republicans in Florida and 21 other states are blocking Medicaid expansion -

http://www.tampabay.com/news/health/health-insurance-for-all-in-florida-1-million-will-be-left-out/2144336

[ApatheticNoMore]

I'm not sure I'd move to California (course it's a pretty expensive place to live anyway), yes there's Medicaid but it's hard to get a doctor that will take it, CA has cut back reimbursement to Medicaid doctors a lot, some of that might improve as the state budget improves I guess. Then the cheapest health insurance plan under the ACA here has massively cut back the amount of doctors and hospitals you can see - it's a very small network to get the cheapo plan.

Another thing to watch out for if you get Medicaid in ANY state and are 55 or over is they can take the money you got from Medicaid out of your estate when you die (any money that is left when you die, not a problem if you planned to die broke or leave it all to homeless cats anyway, but certainly in the big picture societal view a way of making sure those less well off don't pass down anything, not even their residence).

[iris lilies]

Sadly, in FL it's not just income. My income is aboiut $500 a month but I have aqssets greate than $2,000 so I was turned down for Medicaid. For the foreseeable future I'll continue to not have access to jhealth care.

Everyone has to have health insurance come January 2014. Why are you exempt?

[gimmethesimplelife]

There is an exemption in states that have elected not to expand Medicaid for those who are under the amount in which the exchanges will accept you. In Texas over a million people will be falling through this huge crack in the system. And in Texas crossing the border to get health care is very terrifying - they don't have a Los Algodones to go to like I do - the towns that border Texas are full of cartel activity. I am so ashamed of the states in which human life is worth so little, and am glad to live in one that expanded Medicaid. How could I live in a state that didn't opt for it's expansion, morally, spiritually, and financially? Rob

[try2bfrugal]

I'm not sure I'd move to California (course it's a pretty expensive place to live anyway), yes there's Medicaid but it's hard to get a doctor that will take it, CA has cut back reimbursement to Medicaid doctors a lot, some of that might improve as the state budget improves I guess. Then the cheapest health insurance plan under the ACA here has massively cut back the amount of doctors and hospitals you can see - it's a very small network to get the cheapo plan.

Another thing to watch out for if you get Medicaid in ANY state and are 55 or over is they can take the money you got from Medicaid out of your estate when you die (any money that is left when you die, not a problem if you planned to die broke or leave it all to homeless cats anyway, but certainly in the big picture societal view a way of making sure those less well off don't pass down anything, not even their residence).

There are 28 states that have expanded Medicaid under the ACA. I would think finding a doctor to take Medicaid payments is still better than having no insurance at all. I am not sure what your point is.

Do you think it is better to have no insurance at all than it is to have Medicaid?

In the ACA expansion states, there is no asset test for health insurance under Medicaid starting January 1, 2014. Are you sure under the new rules the state will take money from your estate assets for health insurance premium pay back? If so, do you have a reference for that?

[try2bfrugal]

There is an exemption in states that have elected not to expand Medicaid for those who are under the amount in which the exchanges will accept you. In Texas over a million people will be falling through this huge crack in the system. And in Texas crossing the border to get health care is very terrifying - they don't have a Los Algodones to go to like I do - the towns that border Texas are full of cartel activity. I am so ashamed of the states in which human life is worth so little, and am glad to live in one that expanded Medicaid. How could I live in a state that didn't opt for it's expansion, morally, spiritually, and financially? Rob

I think once it is up and running in the states that have chosen expansion many lower income workers will see it as a godsend. Right now not enough people understand how they will benefit.

I just read that even under current programs 2/3 of uninsured children that are eligible for existing programs are not signed up. But maybe the publicity with the ACA will improve those numbers.

[redfox]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

Sure... If I lived in a safe neighborhood, I'd like to walk places. Like to a good grocery store... but those don't exist in my neighborhood. Many of my neighbors rely on food banks to get calories enough to survive. How about in exchange, you change your behavior & limit my liability by getting rid of your guns?

[gimmethesimplelife]

Sure... If I lived in a safe neighborhood, I'd like to walk places. Like to a good grocery store... but those don't exist in my neighborhood. Many of my neighbors rely on food banks to get calories enough to survive. How about in exchange, you change your behavior & limit my liability by getting rid of your guns?+1000 Very well said, Redfox! Rob

[try2bfrugal]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

Alan, do you have some life time guarantee of health insurance some how? Don't you think it is possible some day you or someone you love, might develop a pre-existing condition, or have some financial catastrophe and need help with health insurance yourself some day?

Don't you feel any empathy or concern for a family working minimum wage jobs without insurance and a child with cancer?

[gimmethesimplelife]

Alan, do you have some life time guarantee of health insurance some how? Don't you think it is possible some day you or someone you love, might develop a pre-existing condition, or have some financial catastrophe and need help with health insurance yourself some day?

Don't you feel any empathy or concern for a family working minimum wage jobs without insurance and a child with cancer?+1 Rob I honestly can not understand those folks out there who don't understand this wisdom that you have posted here try2befrugal. Thank you for shedding very human light on this issue.

[ApatheticNoMore]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

well the plan is continued employer subsidy, but yea sure while there are even more perfect people than me in terms of health habits, I'm a pretty good model of a healthy lifestyle (my weaknesses: stress!!! and sugar usually in the form of chocolate bars). But I eat boatloads of food made with good ingredients from scratch, lots of veggies, etc.. I often walk at breaks at work, the area is polluted (from car exhaust of course), so it's not ideal, but it's exercise (and while the sun is still out so better for circadian rhythms). If anything I've been exercising more, adding 10 minutes of walking in the morning sun near my place before I head to work when I can (again circadian rhythms), and stretching in the evening (for anxiety before bed). I'll walk at all hours here if I have mental energy to burn, but it's safe as I rent where I could *NEVER* afford to buy (and I may pay the price financially for that).

[Alan]

Sure... If I lived in a safe neighborhood, I'd like to walk places. Like to a good grocery store... but those don't exist in my neighborhood. Many of my neighbors rely on food banks to get calories enough to survive. How about in exchange, you change your behavior & limit my liability by getting rid of your guns?
I'm sorry you live in a bad neighborhood but since I live about 2400 miles away and have zero impact on your health, safety or well-being, I'm not sure how to fix that for you, although I'm willing to try. Would it help if I sent you one of my guns and considered voting for Hillary in 2016? Other than that, I'm at a loss as to what behavior I could change for you.

[iris lilies]

...I just read that even under current programs 2/3 of uninsured children that are eligible for existing programs are not signed up. But maybe the publicity with the ACA will improve those numbers.

My state advertises those insurance programs for qualifying children, advertises on tv.

[iris lilies]

I'm sorry you live in a bad neighborhood but since I live about 2400 miles away and have zero impact on your health, safety or well-being, I'm not sure how to fix that for you, although I'm willing to try. Would it help if I sent you one of my guns and considered voting for Hillary in 2016? Other than that, I'm at a loss as to what behavior I could change for you.

Don't you dare vote for Hilary!

[Alan]

Don't you dare vote for Hilary!
Ha, I only promised to consider, not that I would actually do it.

[Alan]

Alan, do you have some life time guarantee of health insurance some how? Don't you think it is possible some day you or someone you love, might develop a pre-existing condition, or have some financial catastrophe and need help with health insurance yourself some day?

Don't you feel any empathy or concern for a family working minimum wage jobs without insurance and a child with cancer?Yes, as I approach my retirement years and worry about the future of my special needs grandson, I feel great concern on a personal level. And on a societial level, I worry about people such as the OP who is now facing increased difficulties as a result of the Affordable Care Act requirements.

I think it's important to remind others, who may revel in the fact that the negatives involved with their life choices have now been mitigated by the increased demands upon their neighbors, that their benefit is someone else's loss. Forced participation in higher cost plans and subsidy dollars forcefully taken from their neighbors have a negative impact on more folks than are rewarded with the result.

[gimmethesimplelife]

Don't you dare vote for Hilary!That's cool if you don't vote for her as I will.....Seriously, I wonder if she's going to be running in 2016? Rob

[try2bfrugal]

Yes, as I approach my retirement years and worry about the future of my special needs grandson, I feel great concern on a personal level. And on a societial level, I worry about people such as the OP who is now facing increased difficulties as a result of the Affordable Care Act requirements.

I think it's important to remind others, who may revel in the fact that the negatives involved with their life choices have now been mitigated by the increased demands upon their neighbors, that their benefit is someone else's loss. Forced participation in higher cost plans and subsidy dollars forcefully taken from their neighbors have a negative impact on more folks than are rewarded with the result.

Aren't you happy to know that your special needs grandson and everyone else's special needs children and grandchildren will no longer be excluded from health care, if their parent's lose their jobs?

Does it make any more sense to lose your homeowners insurance or your car insurance when you lose a job?

Having the government help to provide health care for the population isn't some failed social experiment. It is the way the vast majority of the developed world works. It is the way the countries that score higher than the U.S. on happiness and life satisfaction scales work. Almost all other developed countries provide universal health care as a basic population need, like education or police protection. Here is a map of the countries that provide universal health care -

http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

[ApatheticNoMore]

Yea those countries have good systems to some degree whereas at the best the people I care about will be left with garbage Medicaid, which like I said almost no doctors are even taking.

Those I care about that I worry about: smoke a pack a day, does nothing all day most days but sit in front of the t.v., eat nothing but junk food, avoid vegetables like the plague, take a dozen pharma pills a day that I'm sure is making them sicker and sicker, and have worse and worse health reports everytime they go to the doctor and they are in their early 30s, wont' get therapy either (though I guess I could make the offer to pay for it). Do I worry they will have health problems? I know it, it's pretty much inevitable. Dead in 10 years, it wouldn't surprise me AT ALL, that's a funeral I would not be surprised to attend. But not only will they not change their health behaviors they also won't ever get a job, have NEVER held a job of ANY sort, won't ever think about working even, don't even have the dignity of being full time students or aspiring musicians or vagabonds or something (it's literally spending one's entire life in front of the t.v.). So .... noone is that deep pockets richy rich to support them long term and they bring in no income, so the only healthcare they can qualify for is subsidized is garbage California medicaid that's complete garbage (they have private coverage now paid for by others of course). Do I know someday someone will probably be left with a big bill for them that can never be paid? Probably. Would there be some advantage to a real healthcare system (not utter and complete corporate garbage like the ACA so I wouldn't have to worry about it personally). Yes!!! I don't actually support them financially, In my dreams I tell them to "F off" and then discuss how justified I am, and I probably would be, but even in my dreams my heart splits in two. I have tried to save them a 1000 times. I can not but will probably keep trying. But yes it's not really fair for family members to bear the burden of BAD family members who are only capable of self-destruction 24/7 (it's really when the truth is told not our fault we were born into rotten families).

[try2bfrugal]

Yea those countries have good systems to some degree whereas at the best the people I care about will be left with garbage Medicaid, which like I said almost no doctors are even taking.

So your point is that they are much better off with no health care and zero doctors than they are with free health care that includes some but not all doctors and hospitals as participating plan providers?

[Alan]

...Almost all other developed countries provide universal health care as a basic population need, like education or police protection. Here is a map of the countries that provide universal health care -

http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/
But that's not what our government gave us. One party gave us what they wanted us to have and it is not universal health care. It is a bad law that violates democratic principles in that the majority of the citizens are against it, and it violates republican principles in that it places the government over the individual. It is filled with flaws and cannot be instituted fairly as a result of all the waivers from compliance that are necessary to keep from further weakening an already struggling economy. Even with that, it forces many businesses to scale back on hiring decisions and reduce hours to many existing employees rather than reduce their workforce.

It is, in my opinion, a piece of vanity legislation that does more long term harm than good.

If universal health care was what you wanted, you'd be better off petitioning your representatives to replace this law with the real deal. One party created this one without a single vote from the opposition. Maybe if there was enough support from like minded citizens, they'd do a better job next time.

[gimmethesimplelife]

Aren't you happy to know that your special needs grandson and everyone else's special needs children and grandchildren will no longer be excluded from health care, if their parent's lose their jobs?

Does it make any more sense to lose your homeowners insurance or your car insurance when you lose a job?

Having the government help to provide health care for the population isn't some failed social experiment. It is the way the vast majority of the developed world works. It is the way the countries that score higher than the U.S. on happiness and life satisfaction scales work. Almost all other developed countries provide universal health care as a basic population need, like education or police protection. Here is a map of the countries that provide universal health care -

http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/Tnanks for providing this! I often am amazed at how little Americans understand how health care works elsewhere and how our system of health care works against so many of our citizens. It actually boggles my mind. Rob

[ApatheticNoMore]

So your point is that they are much better off with no health care and zero doctors than they are with free health care that includes some but not all doctors and hospitals as participating plan providers?

More just not celebrating a @#$# sandwich that is the ACA as the best thing since sliced bread.

[gimmethesimplelife]

But that's not what our government gave us. One party gave us what they wanted us to have and it is not universal health care. It is a bad law that violates democratic principles in that the majority of the citizens are against it, and it violates republican principles in that it places the government over the individual. It is filled with flaws and cannot be instituted fairly as a result of all the waivers from compliance that are necessary to keep from further weakening an already struggling economy. Even with that, it forces many businesses to scale back on hiring decisions and reduce hours to many existing employees rather than reduce their workforce.

It is, in my opinion, a piece of vanity legislation that does more long term harm than good.

If universal health care was what you wanted, you'd be better off petitioning your representatives to replace this law with the real deal. One party created this one without a single vote from the opposition. Maybe if there was enough support from like minded citizens, they'd do a better job next time.Government over the individual? To be free of the constant fear of getting sick with US citizenship I'm all for that if that is what it takes to have saner health care.....But then I never really bought into America anyway, from a very young age. Perhaps the ACA is not perfect but hot damn, getting more people covered under some kind of insurance? This is a bad thing? I'm sorry, I'm just not understanding this. Rob

[try2bfrugal]

But that's not what our government gave us. One party gave us what they wanted us to have and it is not universal health care. It is a bad law that violates democratic principles in that the majority of the citizens are against it, and it violates republican principles in that it places the government over the individual. It is filled with flaws and cannot be instituted fairly as a result of all the waivers from compliance that are necessary to keep from further weakening an already struggling economy. Even with that, it forces many businesses to scale back on hiring decisions and reduce hours to many existing employees rather than reduce their workforce.

It is, in my opinion, a piece of vanity legislation that does more long term harm than good.

If universal health care was what you wanted, you'd be better off petitioning your representatives to replace this law with the real deal. One party created this one without a single vote from the opposition. Maybe if there was enough support from like minded citizens, they'd do a better job next time.

I feel even if it has its flaws, it is a move in the right direction. It is huge to now be able to get insurance with pre-existing conditions and to decouple health insurance from employment.

What if you didn't have a job you couldn't get car insurance? Does that make any sense?

BTW, according to Forbes, only 1/3 of the U.S. population want to repeal Obamacare -

http://www.forbes.com/sites/theapothecary/2013/09/30/new-poll-only-one-third-of-americans-support-repealing-defunding-or-delaying-obamacare/

The U.S. has the highest health care costs in the world for not very highly rated care. All developed countries with universal care have significantly lower costs because the government sets limits on what they will pay. Here are graphs that show health care costs in the U.S. vs other countries -

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

The real gravy train right now is going to the owners and executives in the health care industry, not Medicaid recipients. See the Time article called Bitter Pill -

http://content.time.com/time/magazine/article/0,9171,2136864,00.html

[gimmethesimplelife]

More just not celebrating a @#$# sandwich that is the ACA as the best thing since sliced bread.About Medicaid - I was on it for five months in 2010. I had my first gout attack while I was covered with Medicaid and I went to the clinic that accepted it on the SouthSide of town. Not a great area and I did have to wait an hour to see a doctor. My cost was zero. Was I in pain that hour? You better believe it. Was I grateful to see a doctor - amazed even that my life in America was actually worth such a thing for once? You better believe it. Was I impressed with the service given? You better believe it. I had the chance to get the meds I needed for free. I was utterly amazed by this. Granted a lot more people are going to get on Medicaid in Arizona now and the system will be strained - I'm sure the waits will be longer and the appointments even shorter. But if it gets me the meds I need if something arises, it's better than nothing. I honestly believe if all Americans had experienced the constant fear of what if what if what if in this country if you don't have health insurance, we would have a fairer and more equitable system. Medicaid is better than nothing. Truly it is. And now the flip of this - when I have gone to Mexicali where health care is so so so much more within reach - the service is much better than Medicaid. The waits are much shorter. The staff accommodates you and your schedule. If you walk in without an appointment, they will find a way to squeeze you in. I think it's pretty sad that when I go to Mexico I get better health care than I do in the US even when I have held regular insurance for brief periods of time in the US. And it's definitely better to cross the border and pay out of pocket if you can than to deal with the American system.

So after all that long-windedness - my points are - Medicaid serviceable and impressive for what it is - but not without issues. Ditto regular health insurance in the US.....Very very very sad that by crossing the border into what is considered a third world country I can get the quality of care I aspire to. But - this is what it is and ObamaCare is better than the status quo - not a person I have spoken to over the past few months that has lived in fear of America doesn't understand this. Rob

[try2bfrugal]

More just not celebrating a @#$# sandwich that is the ACA as the best thing since sliced bread.

You still have never answered my question: So your point is that they are much better off with no health care and zero doctors than they are with free health care that includes some but not all doctors and hospitals as participating plan providers?

[gimmethesimplelife]

You still have never answered my question: So your point is that they are much better off with no health care and zero doctors than they are with free health care that includes some but not all doctors and hospitals as participating plan providers?+1 Good point! Thanks for bringing it up.....Rob

[Gardenarian]

Well, my insurance is going down from around $1800/month for a family of three to around $500. (In CA, paying for our own insurance.)

[frugalone]

Wow, I logged on today and there's 9 pages of this discussion!
I'm just going to take this step by step. Waiting until tomorrow to see what happens on the exchanges.

I do see this as an opportunity for health insurance companies to jack their prices up through the roof. I just never dreamed they were going to do away with the program I've had for the past couple of years.

[gimmethesimplelife]

Well, my insurance is going down from around $1800/month for a family of three to around $500. (In CA, paying for our own insurance.)Just curious, if I may? Is this with the tax credit? Or is that just the flat rate before any tax credit? Rob

[redfox]

I'm sorry you live in a bad neighborhood but since I live about 2400 miles away and have zero impact on your health, safety or well-being, I'm not sure how to fix that for you, although I'm willing to try. Would it help if I sent you one of my guns and considered voting for Hillary in 2016? Other than that, I'm at a loss as to what behavior I could change for you.

No thanks to the gun, it's a tool I no longer need. I had & used guns when I farmed, but here in the city, they are inappropriate. Definitely, vote for Ms. Clinton, thanks! You rock.😝

[Gardenarian]

I don't know what the "tax credit" is?
This is for the regular plan through Kaiser Permanente, without subsidies.
We are getting a plan with a very high deductible and will start a health savings account.

[iris lilies]

... I just never dreamed they were going to do away with the program I've had for the past couple of years.


http://us-mg204.mail.yahoo.com/ya/download?mid=2%5f0%5f0%5f1%5f284940%5fAD48w0MAAVR5 Ukm4EQD963wNQJQ&pid=2&fid=Inbox&inline=1&appid=YahooMailNeo




http://tinyurl.com/muaw8nr

(http://tinyurl.com/muaw8nr)http://www.thoughtsfromaconservativemom.com/wp-content/uploads/2013/02/obama-then-i-said-if-you-like-your-health-plan-you-can-keep-it.jpg
(http://tinyurl.com/muaw8nr)

[Miss Cellane]

Well, waiting with bated breath for the reveal tomorrow of my insurance options. Un-or-underemployed for the last 5 years. Currently working a long-term temp job. Just got a letter from the temp agency to let me know I can't get their insurance. But in spite of that, they are legally obligated to send me all the information on their policies. Oh, yea!

Read in the paper today that only one insurance company was willing to provide the low-cost insurance options for my state. So bye-bye any semblance of choice in purchasing insurance. Also that this one company was unwilling to partner with all the hospitals in the state. I guess I am lucky that they were willing to deal with the hospital in my city. Otherwise, based on the list of available hospitals, I'd have had to drive 45 minutes or more. Not sure yet on which doctors will be accepting this insurance. Hope there's someone within 30 or so miles. For people who don't have transportation, this could be a serious problem.

The big question for me is if I will be able to afford even the lowest-cost option. If I can't, I don't know what I'm supposed to do.

[gimmethesimplelife]

Well, waiting with bated breath for the reveal tomorrow of my insurance options. Un-or-underemployed for the last 5 years. Currently working a long-term temp job. Just got a letter from the temp agency to let me know I can't get their insurance. But in spite of that, they are legally obligated to send me all the information on their policies. Oh, yea!

Read in the paper today that only one insurance company was willing to provide the low-cost insurance options for my state. So bye-bye any semblance of choice in purchasing insurance. Also that this one company was unwilling to partner with all the hospitals in the state. I guess I am lucky that they were willing to deal with the hospital in my city. Otherwise, based on the list of available hospitals, I'd have had to drive 45 minutes or more. Not sure yet on which doctors will be accepting this insurance. Hope there's someone within 30 or so miles. For people who don't have transportation, this could be a serious problem.

The big question for me is if I will be able to afford even the lowest-cost option. If I can't, I don't know what I'm supposed to do.If I remember correctly, you are in New Hampshire, right? (I lived the first ten years of my life in Sandown, not too far from the Mass. state line). I think I remember that NH was taking some time to decide if it wanted to expand Medicaid? If they have, and your income in under 15 something K, then you qualify for Medicaid. If your income is over but still not all that hot, then you should qualify for some pretty good subsidies from the government - wait until tomorrow and see how it works for you. I do think that since NH is so small and not heavily urbanized that it might not have the competition that I have in Arizona......hang in there, tomorrow you find out and I wish you the best. Rob

[peggy]

Yea those countries have good systems to some degree whereas at the best the people I care about will be left with garbage Medicaid, which like I said almost no doctors are even taking.

Those I care about that I worry about: smoke a pack a day, does nothing all day most days but sit in front of the t.v., eat nothing but junk food, avoid vegetables like the plague, take a dozen pharma pills a day that I'm sure is making them sicker and sicker, and have worse and worse health reports everytime they go to the doctor and they are in their early 30s, wont' get therapy either (though I guess I could make the offer to pay for it). Do I worry they will have health problems? I know it, it's pretty much inevitable. Dead in 10 years, it wouldn't surprise me AT ALL, that's a funeral I would not be surprised to attend. But not only will they not change their health behaviors they also won't ever get a job, have NEVER held a job of ANY sort, won't ever think about working even, don't even have the dignity of being full time students or aspiring musicians or vagabonds or something (it's literally spending one's entire life in front of the t.v.). So .... noone is that deep pockets richy rich to support them long term and they bring in no income, so the only healthcare they can qualify for is subsidized is garbage California medicaid that's complete garbage (they have private coverage now paid for by others of course). Do I know someday someone will probably be left with a big bill for them that can never be paid? Probably. Would there be some advantage to a real healthcare system (not utter and complete corporate garbage like the ACA so I wouldn't have to worry about it personally). Yes!!! I don't actually support them financially, In my dreams I tell them to "F off" and then discuss how justified I am, and I probably would be, but even in my dreams my heart splits in two. I have tried to save them a 1000 times. I can not but will probably keep trying. But yes it's not really fair for family members to bear the burden of BAD family members who are only capable of self-destruction 24/7 (it's really when the truth is told not our fault we were born into rotten families).

THEM? Them? Really? These are family members? How many? How many family members do you have that fit this profile? 3? 5? 10? 100? Is it a commune of family members who do nothing but sit around watching TV, eating junk food and avoiding sunlight like vampires? Maybe it's like a small village of ding dong eating, jelly like Jabba the Huts with pasty rubber skin as pale as the moon, due to THEIR slovenly loser, 'gonna die in a year and I don't care' lives.
Wow! What a crappy family you must have to have enough pasty faced in-breds to be able to declare the ACA a total loss for the whole of America based on the obviously large (huge!) number of total losers in your family.

On the other hand, if you are 'going on' about one, or maybe two slackers who don't exactly fit YOUR opinion of 'how folks should live', then maybe you, and many here, should just calm down, take a breath, and see how it goes.

See, what you, and most of the 'compassionate conservatives' (cough..yeah, right) fail to realize, or maybe DO realize but don't want the lesser informed to realize, is that you, and I and all us tax-paying 'Mericans WERE ALREADY PAYING FOR THESE PEOPLE. Yeah, that's right. We paid. In higher premiums, in higher medical costs, and in higher taxes. Unless of course you were one of those, like some, who could actually afford health care, but chose simply to, oh I don't know, gas up the boat, instead of getting it, knowing full well they wouldn't be turned away when THEY, or a loved one, needed it.

With Obamacare, most will pay at least something, even if it is a small bit. But, like most dreams in America, it builds on the promise that someday you too will be rich and successful and able to give a bit more, a hand up if you will, just as someone gave you a hand up when you were young and poor. Kind of how SS works. We pay in when we are young and able to work cause we will all be old and unable to work someday. All of us. Every one of us. And every one of us will have increasing health issues...and yes, even those of us who arrogantly chided others for their ding dongs while we chomped our wheat grass. Everyone will get old. And if you don't, then you probably cost even more with your car accident/cancer/gun fight, or whatever caused you to not grow old.

It's a pretty simple principle really. But it's one you won't understand unless you really understand what it means to live in a united society. It's not a straight line. The country is not run by, owned, or for 30-somethings. You are born helpless, in need of care, and chances are you will die fairly helpless (unable to work a hard 40 hour week, or simply 'rub dirt' into what dings you might have) and in need of care.
Hopefully at both ends your family is there to help you, but sometimes, often, they need help. They can't offer neo-natal support in the kitchen, or hip replacement behind the shed. Why is this such a hard concept? And what makes the far right so blind to this simple truth? How many republicans voted against Sandy relief, yet find it appalling that anyone would question THEIR disaster relief? Have we really come to this? Are we really nothing more than Every man for Himself?

I've been trying to avoid these forums lately, and this thread is a perfect example why. The greed and selfishness displayed here is appalling. Someone comes here, in a bit of a panic, asking for advise, and all they get is misinformation, and dire 'warnings' about lazy slackers robbing them of their hard earned pay with their fake heart attacks and well deserved fatal illnesses brought on by life choices (cause, you know, cancer/brain tumors/birth defects/being shot by a neighborhood watch 'hero' is always a choice)
A few here have tried to dispel the false information, but their voices are drowned out by arrogant pronouncements of 'I don't need it or want it, therefore no one needs it or wants it'.
Such self centered arrogance. Not surprising, but disappointing just the same.

[gimmethesimplelife]

THEM? Them? Really? These are family members? How many? How many family members do you have that fit this profile? 3? 5? 10? 100? Is it a commune of family members who do nothing but sit around watching TV, eating junk food and avoiding sunlight like vampires? Maybe it's like a small village of ding dong eating, jelly like Jabba the Huts with pasty rubber skin as pale as the moon, due to THEIR slovenly loser, 'gonna die in a year and I don't care' lives.
Wow! What a crappy family you must have to have enough pasty faced in-breds to be able to declare the ACA a total loss for the whole of America based on the obviously large (huge!) number of total losers in your family.

On the other hand, if you are 'going on' about one, or maybe two slackers who don't exactly fit YOUR opinion of 'how folks should live', then maybe you, and many here, should just calm down, take a breath, and see how it goes.

See, what you, and most of the 'compassionate conservatives' (cough..yeah, right) fail to realize, or maybe DO realize but don't want the lesser informed to realize, is that you, and I and all us tax-paying 'Mericans WERE ALREADY PAYING FOR THESE PEOPLE. Yeah, that's right. We paid. In higher premiums, in higher medical costs, and in higher taxes. Unless of course you were one of those, like some, who could actually afford health care, but chose simply to, oh I don't know, gas up the boat, instead of getting it, knowing full well they wouldn't be turned away when THEY, or a loved one, needed it.

With Obamacare, most will pay at least something, even if it is a small bit. But, like most dreams in America, it builds on the promise that someday you too will be rich and successful and able to give a bit more, a hand up if you will, just as someone gave you a hand up when you were young and poor. Kind of how SS works. We pay in when we are young and able to work cause we will all be old and unable to work someday. All of us. Every one of us. And every one of us will have increasing health issues...and yes, even those of us who arrogantly chided others for their ding dongs while we chomped our wheat grass. Everyone will get old. And if you don't, then you probably cost even more with your car accident/cancer/gun fight, or whatever caused you to not grow old.

It's a pretty simple principle really. But it's one you won't understand unless you really understand what it means to live in a united society. It's not a straight line. The country is not run by, owned, or for 30-somethings. You are born helpless, in need of care, and chances are you will die fairly helpless (unable to work a hard 40 hour week, or simply 'rub dirt' into what dings you might have) and in need of care.
Hopefully at both ends your family is there to help you, but sometimes, often, they need help. They can't offer neo-natal support in the kitchen, or hip replacement behind the shed. Why is this such a hard concept? And what makes the far right so blind to this simple truth? How many republicans voted against Sandy relief, yet find it appalling that anyone would question THEIR disaster relief? Have we really come to this? Are we really nothing more than Every man for Himself?

I've been trying to avoid these forums lately, and this thread is a perfect example why. The greed and selfishness displayed here is appalling. Someone comes here, in a bit of a panic, asking for advise, and all they get is misinformation, and dire 'warnings' about lazy slackers robbing them of their hard earned pay with their fake heart attacks and well deserved fatal illnesses brought on by life choices (cause, you know, cancer/brain tumors/birth defects/being shot by a neighborhood watch 'hero' is always a choice)
A few here have tried to dispel the false information, but their voices are drowned out by arrogant pronouncements of 'I don't need it or want it, therefore no one needs it or wants it'.
Such self centered arrogance. Not surprising, but disappointing just the same.Gotta say you raise good points here Peggy. I myself am amazed at some of what is posted here and how it comes across as every person for themselves. I try to tell myself that such people have known economic stability and that they have never had reason to fear the United States and what it is all about - but sometimes it's just hard for me to accept it, period. I am not an evil person but sometimes I do have a dark side and I wish such people some economic challenges in which they learn about my America - but OTOH I also know that my America is sifting upwards these days. I'm guessing there's a lot of denial and debt going on out there to keep up appearances.

But I have some hope. A couple of weeks ago I was taking my mom's cat to the vet for her, and I overheard a group of young vet techs candidly discussing which country they wanted to immigrate to - I was happy that the vet tech that dealt with my mom's cat said and I quote verbatim - "there's really no reason to stay in America anymore, if you do, what's in it for you?" That gave me so so so much hope. Of course this is just an isolated incident but if there are these few young people talking reality there must be more elsewhere. So there is some common sense and hope out there. I try to remember that.

I just looked up yahoo.com news and I see that the deadline has been reached and a shutdown is indeed taking place. Amazing to me. My takeaway from this is that the Republicans could care less about human life as they are trying very tenaciously to block legislation that would cover more citizens with health insurance. I see this as proof that many Americans just don't care about human life or other people and I don't know that I will ever forgive or forget this - regardless of what happens next. But there also those who support Obama, who support the ACA, that are fighting for the right to have the human dignity that health insurance offers. And there are those who are young who are reevaluating if remaining in America is a viable choice for the future. I do draw hope from such.

Rob

[ApatheticNoMore]

The advice part was to research the options more (by going on the exchanges, by talking to "navigators", whatever), that's the best possible advice anyone can give unless they are expert in the subject. Do research before catastrophizing. Not because laws or never unfair or because they might not get screwed (because I hold no such grand overarching beliefs about the infinite wisdom of the laws and the government or anything - my worldview doesn't require me to) but merely for the rational reason that nothing can be known with inadequate information!

That laws can be tough to navigate and adequate information difficult to find, I know. The advice was given very early on, I said these exact things, 9 pages on yea discussions turn to politics (and not by me - people post pages and pages of political stuff, making the whole thread about their politics which is always the same rant, and then object when anyone else becomes political in it), but the advise was: do the research. It's the best, most rational advise I know how to give. But then I don't consider my job to be some grand expert on Obamacare dispelling misinformation (my heavens, what would my qualifications be for that? what are anyones? reading some biased propaganda?), that's why I point to places were information might *actually* be found (ie go on the exchanges, talk to the navigators even if they aren't very good, and yea talk to the health insurance company and the employer as well, sure maybe even a CPA or a financial adviser might help although I'm not sure how qualified they are for that either).

[iris lilies]

... My takeaway from this is that the Republicans could care less about human life as they are trying very tenaciously to block legislation that would cover more citizens with health insurance...

Rob

Let's see, the President and his minions have already pushed off several provisions of the law, delaying what he wanted to put into place, and now he won't compromise and push off on the individual mandate. He's offered a compromise and he's not having any of it.

Who is it that isn't compromising these days?

[gimmethesimplelife]

Let's see, the President and his minions have already pushed off several provisions of the law, delaying what he wanted to put into place, and now he won't compromise and push off on the individual mandate. He's offered a compromise and he's not having any of it.

Who is it that isn't compromising these days?To me compromise means give a little, get a little. Obama has already given a little - he has granted a one year delay in part of ObamaCare. It is now time for the Republicans to give a little and they refuse to and would rather shut down the government. I think right now Conservatives are showing their true colors as to how little human life means to them and how little even this country means to them - they are all about the dollar. And I'm not saying the Dems are all that different - their one difference is that they will throw bones out to the downtrodden. And in this country, that's the most one can hope for these days in a lot of cases. Rob

[ApatheticNoMore]

I think right now Conservatives are showing their true colors as to how little human life means to them and how little even this country means to them - they are all about the dollar. And I'm not saying the Dems are all that different - their one difference is that they will throw bones out to the downtrodden.

then why use such strong words if really "they're mostly all the same anyway". Unless the critique is much broader aka "the rulers/the ruling class/those in power don't care about human life". For me showing how little one cares about human life is shown by having an assassination program. end. full stop. nothing more to say.

But the budget that's a whole nuttiness of it's own and the Republicans do mostly own that.

[Zoebird]

So, a couple of weeks ago, I looked online on some various sites and compared prices of insuring my family.

I was basically looking for as good or better than what we had when DH last worked in a company -- for which we contributed $280/mo -- the company apparently paid the rest -- and it wasn't a plan of our choosing, with a terrible network (we went to an out of network doctor and paid $75 per appointment), and basically was a PITA to use (ie, try getting your free bi-annual physical, I dare ya! Yeah, definitely get your teeth cleaned and checked once a year! do that!).

So, anyhoot, found a better-than-we-had aetna (nice network!) coverage for $335. Not too shabby, considering the coverage was better (ie, $5k family deductible instead of $10k, great dental coverage, better catastrophic injury and disease coverage, etc).

Then, you know, today -- day one of the exchange being open -- I first went to try the exchange but I think the web site was running a bit slow because of load or something. So, went back to my other web sites to see what deals I might get just on the regular market.

Same aetna coverage -- $270. Heh. Winning!

[ApatheticNoMore]

I've been paying $300 a month for just myself. Oh the glories of employer provided insurance.

[sweetana3]

peggy, no matter where you go this is the discourse about the ACA.

I prefer to believe that it is fear. Fear of the unknown, fear of inadequate government, created by the media, fear of others again created by our media, fear of change. My assumptions may not be true but it helps me keep some equilibrium in this whole mess.

Most of the decisions we made over our career were about not losing health insurance and retirement. I remember decades ago telling other women that they had to consider protecting themselves since "spouses" were not in the same class as employees when it came to retiree health care. I was considered crazy. I also told them to be aware that their jobs could be done anywhere there was a phone and they needed to make sure they showed they were needed. I don't like seeing my predictions come true.

[Miss Cellane]

The advice part was to research the options more (by going on the exchanges, by talking to "navigators", whatever), that's the best possible advice anyone can give unless they are expert in the subject. Do research before catastrophizing. Not because laws or never unfair or because they might not get screwed (because I hold no such grand overarching beliefs about the infinite wisdom of the laws and the government or anything - my worldview doesn't require me to) but merely for the rational reason that nothing can be known with inadequate information!

That laws can be tough to navigate and adequate information difficult to find, I know. The advice was given very early on, I said these exact things, 9 pages on yea discussions turn to politics (and not by me - people post pages and pages of political stuff, making the whole thread about their politics which is always the same rant, and then object when anyone else becomes political in it), but the advise was: do the research. It's the best, most rational advise I know how to give. But then I don't consider my job to be some grand expert on Obamacare dispelling misinformation (my heavens, what would my qualifications be for that? what are anyones? reading some biased propaganda?), that's why I point to places were information might *actually* be found (ie go on the exchanges, talk to the navigators even if they aren't very good, and yea talk to the health insurance company and the employer as well, sure maybe even a CPA or a financial adviser might help although I'm not sure how qualified they are for that either).


Oh, I so agree with this. The rumors that are flying around--I work as a temp, with a lot of other long-term temps and contract workers. We will all be affected by this. I haven't had health insurance in 5 years. I've been to a walk-in clinic once in that time, when I had an abscess in my jaw so painful I couldn't sleep. It cost: $99 for the visit, $89 for the antibiotics (after they figured out a way to give me the same dose for less money--it was going to cost $110) and $11 for the Vicodin. That was pretty much my food budget for the month. Everything else, I've just toughed my way through.

But the rumors that are floating through my workplace are unbelievable. Every night I come home and go on the internet and find out that the latest rumor is false. Sometimes the exact opposite of the rumor is the truth.

Why people are relying on hearsay and gossip instead of getting on the internet or going to the library and reading the newspaper is beyond me. They are making themselves scared and anxious when, for most of them, there is no real reason to do so.

[gimmethesimplelife]

I don't know what the "tax credit" is?
This is for the regular plan through Kaiser Permanente, without subsidies.
We are getting a plan with a very high deductible and will start a health savings account.The tax credit is the amount of instant subsidy you are granted by the Federal Government, which lowers the amount you have to pay for your monthly premium based on your income. Naturally, the lower your income, the higher the subsidy. I do think it is confusing to call this a tax credit but since the IRS is getting involved in this, maybe it does make sense. Rob

[flowerseverywhere]

One party created this one without a single vote from the opposition. Maybe if there was enough support from like minded citizens, they'd do a better job next time.

where was the oppositions plan? Surely all of those minds could have said early on, wait a minute, how about this plan that will help more people get insurance, control the skyrocketing premiums that people were facing and help those who were bumped off the rolls due to pre.existing conditions that wanted insurance? Or those who reached a lifetime max? Surely there was another plan they crafted?

[iris lilies]

I've been paying $300 a month for just myself. Oh the glories of employer provided insurance.

Why don't you opt out of it then?

We pay 100% of DH's health insurance, a plan that is available through my work. His friends, also self employed, have plans that are much cheaper. And besides, he is healthy and we could really get by just fine with a catastrophic plan. But I am content with this plan from work because I'm not experienced in reading health insurance plans/options/provisions and I know that my plan at work covers bunches of things, there are no hidden surprises. I like having something that is known to be very reliable and I'll just pay that upper cost for it, kind of like a newish cars vs an old beater.

Our plan doesn't cover dental or vision care (and this glasses are uber expensive) but that's fine, we pay for that out of pocket, it's not a big deal.

We could certainly save money on health insurance even at our advanced age, but the risk of moving to an unknown and lesser plan isn't worth it to me.

[iris lilies]

peggy, no matter where you go this is the discourse about the ACA.

I prefer to believe that it is fear. Fear of the unknown, fear of inadequate government, created by the media, fear of others again created by our media, fear of change. My assumptions may not be true but it helps me keep some equilibrium in this whole mess.

Most of the decisions we made over our career were about not losing health insurance and retirement. I remember decades ago telling other women that they had to consider protecting themselves since "spouses" were not in the same class as employees when it came to retiree health care. I was considered crazy. I also told them to be aware that their jobs could be done anywhere there was a phone and they needed to make sure they showed they were needed. I don't like seeing my predictions come true.

You are a very sensible person.

So were you acting out of "fear?" I think so. Fear that your job or spouse's job would go away. Fear that you or spouse wouldn't be covered by employer's health plan (and I've never worked for anyone that has "family" coverage so it's not exactly a fear, it's reality in my world.) Fear that without health insurance you loose wealth, retirement savings. Nothing wrong with that. Fear of having no money has driven many of my decisions as an adult.

Fear of unintended consequences of Nanny G meddling in society is, in my mind, a reasonable outlook. Call it "fear" or common sense observation of consequences of an "inadequate government" because guess what, that happens. I live two blocks away from a social experiment that turned me from voting lefty to righty. The gubmnt really can f*ck things up like no one else.

[Suzanne]

" And I'm always just: ok how does anyone actually afford to live with kids (and especially with a non-working spouse). Haha, if that was me, I'd me I'd tell the spouse: get a job with health insurance or get out of the house! "

So, if you lost your job and couldn't find another before your benefits ran out, you would immediately and voluntarily leave the house to spare your still-employed spouse the costs of your health insurance???

[ApatheticNoMore]

So, if you lost your job and couldn't find another before your benefits ran out, you would immediately and voluntarily leave the house to spare your still-employed spouse the costs of your health insurance???

What I've always tried to actually do when unemployed - get on CORBA, now CORBA is expensive (although not that much more than my current plan), and because I forgot one payment last time I was on CORBA (yes fine I missed a payment, therefore consequences, I didn't go on and on about it, but I will say it's a harsh system that being late for one payment can permanently cut you off - and it doesn't matter if you want to pay the full amount you owe now plus interest - you were late - bye bye forever), I lost the CORBA and was without health insurance for awhile. So yea I was without insurance. So I don't know I suppose if I had a spouse I'd try to do the exact same thing go on CORBA (or now the ACA depending on which was a better deal). A social safety net that applies to everyone in the country equally? Sure. But relying on a spouse, but I was brought up to be a feminist ...

[Zoebird]

accidental double

[Zoebird]

ANM,

No, I hear you.

A friend of mine owns a small company that employs 12 people. He has always provided a premium insurance package for families of his employees. Right now, the company gave him the costs for her current plan per individual and per family (based on the people currently enrolled), and it's so cost prohibitive, that in order to remain viable, he'd have to let go of two employees.

So, his options are to decrease their coverage and increase their contribution -- both of which are crappy, but the best he can do.

And I said that the options are actually better. He can keep the benefit as is, increase their contribution, and if that's more than what they would pay ont he exchange, then they can stay, and if it's more, than he can recommend they go on the exchange and anyone who does go on the exchange can get a match in their monthly pay checks.

He did the numbers, and is talking to a lawyer today. It might fit within the guidelines.

Also, you might discover if you do go independently, particularly on the exchange, that you might get a better deal.

[peggy]

What I've always tried to actually do when unemployed - get on CORBA, now CORBA is expensive (although not that much more than my current plan), and because I forgot one payment last time I was on CORBA (yes fine I missed a payment, therefore consequences, I didn't go on and on about it, but I will say it's a harsh system that being late for one payment can permanently cut you off - and it doesn't matter if you want to pay the full amount you owe now plus interest - you were late - bye bye forever), I lost the CORBA and was without health insurance for awhile. So yea I was without insurance. So I don't know I suppose if I had a spouse I'd try to do the exact same thing go on CORBA (or now the ACA depending on which was a better deal). A social safety net that applies to everyone in the country equally? Sure. But relying on a spouse, but I was brought up to be a feminist ...

Ok, see, that is the beauty of Obamacare. The insurance company CAN'T just arbitrarily kick you off! That's it! You get it! Or maybe you don't realize you get it. But all the health care horror stories I'm reading here are the VERY ISSUES OBAMACARE IS TRYING TO ADDRESS!
People being kicked off for no good reason, losing their life savings/going bankrupt from health costs, spouses being screwed for being, well, spouses. These ARE the issues Obamacare addresses. Despite all the scare-mongering the right is throwing out (and they are DESPERATE now) The ACA is more just a set of regulations for the insurance industry than anything, coupled with personal responsibility for everyone to accept at least a small portion of their health care costs, even if it's just a small part.

I would urge everyone to cut through the BS flowing from those who have a vested interest in the ACA NOT being fully implemented, and seek the truth. Go to the gov sites and see for yourself. And while you are there, check out the nifty little chart that compares your state to other states. Especially those of you who have republican legislatures who refuse, and actually throw up roadblocks, to you getting the best deal/health care available. Keep in mind that these people are so bent on their hatred of Obama, and keeping Obama from achieving anything, at all, they are willing to toss their own citizens of their states under the bus. They want them to have as much trouble getting affordable health care as they can. They WANT them to be miserable. Think about that. And remember it. But do the comparison.

Neil deGrasse famously said that the best thing about science is that it's true, whether you believe it or not. The same goes for facts. Get the facts.

[try2bfrugal]

Ok, see, that is the beauty of Obamacare. The insurance company CAN'T just arbitrarily kick you off! That's it! You get it! Or maybe you don't realize you get it. But all the health care horror stories I'm reading here are the VERY ISSUES OBAMACARE IS TRYING TO ADDRESS!
People being kicked off for no good reason, losing their life savings/going bankrupt from health costs, spouses being screwed for being, well, spouses. These ARE the issues Obamacare addresses. Despite all the scare-mongering the right is throwing out (and they are DESPERATE now)

Well said. It seems from here and other forums many people are rallying against the ACA who will benefit greatly from its provisions. And many others who are one job loss away from benefiting but for some reason can't understand the "there but for but the grace of God go I" aspect.

[ApatheticNoMore]

Well the thing is the weaknesses with Corba, since Corba is a government program anyway (which doesn't mean there's any heavy subsidization, it's mostly just buying at the employer rate) could have been addressed anyway if anyone in power had cared to. Clearly noone ever did. (Although honestly people who don't pay their bills on time and then get kicked out aren't the most sympathetic victims in the world).

[try2bfrugal]

Well the thing is the weaknesses with Corba, since Corba is a government program anyway (which doesn't mean there's any heavy subsidization, it's mostly just buying at the employer rate) could have been addressed anyway if anyone in power had cared to, clearly noone ever did. (Although honestly people who don't pay their bills on time and then get kicked out aren't the most sympathetic victims in the world).

So would you go back to the old way of no COBRA for you since you missed a single payment, and no health care for your relatives, or subsidized, affordable health care under the ACA, whether you are employed or not, and Medicaid for your family?

You don't have any third choices. There are only these two options. Go forward with something that is not perfect but 85% better or go back to where you miss a COBRA payment, maybe get cancer and die untreated because you have a pre-existing condition and can't get any other insurance even if you could manage to pay for it?

[bae]

Well the thing is the weaknesses with Corba, since Corba is a government program anyway (which doesn't mean there's any heavy subsidization, it's mostly just buying at the employer rate) could have been addressed anyway if anyone in power had cared to. Clearly noone ever did. (Although honestly people who don't pay their bills on time and then get kicked out aren't the most sympathetic victims in the world).

COBRA. Consolidated Omnibus Budget Reconciliation Act.

Corba - Common Object Request Broker Architecture.

[ApatheticNoMore]

Corba - Common Object Request Broker Architecture.

I actually vaguely remember that. Vaguely, very vaguely :)

[bae]

I actually vaguely remember that. Vaguely, very vaguely :)

Oh my, I am so terribly terribly sorry! I did not mean to expose you to those trigger words!

What medications did they put you on? They told me last year they expect to be able to take off my nice white jacket any day now!

[gimmethesimplelife]

Ok, see, that is the beauty of Obamacare. The insurance company CAN'T just arbitrarily kick you off! That's it! You get it! Or maybe you don't realize you get it. But all the health care horror stories I'm reading here are the VERY ISSUES OBAMACARE IS TRYING TO ADDRESS!
People being kicked off for no good reason, losing their life savings/going bankrupt from health costs, spouses being screwed for being, well, spouses. These ARE the issues Obamacare addresses. Despite all the scare-mongering the right is throwing out (and they are DESPERATE now) The ACA is more just a set of regulations for the insurance industry than anything, coupled with personal responsibility for everyone to accept at least a small portion of their health care costs, even if it's just a small part.

I would urge everyone to cut through the BS flowing from those who have a vested interest in the ACA NOT being fully implemented, and seek the truth. Go to the gov sites and see for yourself. And while you are there, check out the nifty little chart that compares your state to other states. Especially those of you who have republican legislatures who refuse, and actually throw up roadblocks, to you getting the best deal/health care available. Keep in mind that these people are so bent on their hatred of Obama, and keeping Obama from achieving anything, at all, they are willing to toss their own citizens of their states under the bus. They want them to have as much trouble getting affordable health care as they can. They WANT them to be miserable. Think about that. And remember it. But do the comparison.

Neil deGrasse famously said that the best thing about science is that it's true, whether you believe it or not. The same goes for facts. Get the facts.Bravo, Peggy! I agree with what you have posted here. That being said, I do believe, as I have posted elsewhere, that the Obama administration has not done an effective job in educating the public about ObamaCare, and due to this, all kinds of misinformation is out there. I really hold the administration accountable for this - It's almost as if Barak was thinking, Ok, I've got the masses covered, leave me in peace now so I can go play a few more rounds of golf. Or something like that. Great that ObamaCare has survived and is being more and more implemented, don't get me wrong, but poor communication/education about what ObamaCare is all about and what's in it for the average person/why exactly should they support it. Rob

[CeciliaW]

A quick note, not having read all 11 pages of posts, but today when the Cover.Oregon website went live, I went there, plugged my numbers in and was given a choice of 13 different plans at 3 different levels, ranging from about $400-$535 and an estimate of what the subsidy would be. For me it will be amazing to have access, even with the deductible.
I know I'm not the only one on these boards that has been paying cash for years and years.
Everyone I've talked to that has looked at the real numbers has been pleasantly surprised.
Let's give it another few months to settle in.

[ApatheticNoMore]

Give it another 10 years (or at least 5) to determine if it's really controlled costs. Because aren't the basic things that are broken: ok the insurance system to some degree but it may not be the worst of it, runaway hospital pricing, runaway pharma pricing.

[gimmethesimplelife]

A quick note, not having read all 11 pages of posts, but today when the Cover.Oregon website went live, I went there, plugged my numbers in and was given a choice of 13 different plans at 3 different levels, ranging from about $400-$535 and an estimate of what the subsidy would be. For me it will be amazing to have access, even with the deductible.
I know I'm not the only one on these boards that has been paying cash for years and years.
Everyone I've talked to that has looked at the real numbers has been pleasantly surprised.
Let's give it another few months to settle in.I'm glad you had a pleasant experience with the Oregon exchange. Here in Arizona I was able to create an account but am able to go no further than that - I am hoping that the glitches can be worked out soon so that I can get online and get insured.....Rob

[peggy]

Bravo, Peggy! I agree with what you have posted here. That being said, I do believe, as I have posted elsewhere, that the Obama administration has not done an effective job in educating the public about ObamaCare, and due to this, all kinds of misinformation is out there. I really hold the administration accountable for this - It's almost as if Barak was thinking, Ok, I've got the masses covered, leave me in peace now so I can go play a few more rounds of golf. Or something like that. Great that ObamaCare has survived and is being more and more implemented, don't get me wrong, but poor communication/education about what ObamaCare is all about and what's in it for the average person/why exactly should they support it. Rob

Exactly Rob! I don't see it as him just moving on to other things, but actually kind of like the higher math teacher. We all had that teacher...knows math inside and out and understands it standing on his/her head, but just can't understand why 'we' can't get it! It's so plain! It's right there! >8)
I think Obama sees how it works and will benefit the country now and into the future, and can't understand how anyone can't see that. Some of us can, but a whole lot can't, and I agree with you that their biggest failing is in getting the right/factual information out. The democrats are not exactly known for their good PR!;)

[frugalone]

Well, our local Blue Cross/Blue Shield site isn't working properly yet. They can't let me know if I qualify for a subsidy or not. Without a subsidy, the prices are higher than what I would pay through my employer.

Sometimes I wonder if I'm living in some sort of bubble. I'm in sticker shock, constantly. Like last year, I posted about my brother's car payment being $440 a month. That's more than I pay in rent. People told me that was fairly typical for a car payment. The last car payment I had was $80 a month (back in the '80s; and it was a used car). My rent has been my highest expense, next to food. I guess I need to get used to the fact that I'm not going to get away with a low health insurance premium. :( Very sad.

[Spartana]

Well, yesterday we got a letter from BC/BS with the bad news: They are dropping our special program. And there are five brochures full of info about their "new plans"--with outrageous prices
I got that same letter from BC for my bare-bones plan - as did my sister (who nows has employer coverage via Kaiser) got from Aetna (and apparently Aetna is pulling out of Calif completely on Jan. 1st) who she had while unemployed. A friend got a similair letter from another insurance carrier - Healthnet. For myself, as a military veteran with a service connected disability rated by the VA, I will drop my BC coverage and use the VA exclusively at no or little cost to me and not purchase any health insurance (I don't qualify for subsidies anyways only medicaid).

[Spartana]

Alan, I didn't know that. I thought the idea was just to provide everyone with SOME sort of coverage, rather than having a large amount of uninsured. I seem to fall somewhere in the middle. Our household income is too high for us to get any kind of public "relief" and it's too low for me to comfortably afford the premiums. I'm lucky that my employer does offer some sort of insurance. But it's quite clear from the large leap in price that I can see on the forms at work that they do NOT want to pay for family members. They're more than happy to just cover the employee--but add a family member (or two or three) and the price skyrockets. I have some friends who are very low income (minimum wage) and are supporting a few kids on that. They have employer health coverage but with very high out-of-pocket costs share for their monthly premiums to cover themselves and their family. However I don't believe that they will be able to recieve any subsidies even if they are below poverty level since the ACA doesn't apply to people who have health insurance available from their employers even if they are extremely low income. A group in dire need of help that got missed by the ACA. Sad.

[try2bfrugal]

I have some friends who are very low income (minimum wage) and are supporting a few kids on that. They have employer health coverage but with very high out-of-pocket costs share for their monthly premiums to cover themselves and their family. However I don't believe that they will be able to recieve any subsidies even if they are below poverty level since the ACA doesn't apply to people who have health insurance available from their employers even if they are extremely low income. A group in dire need of help that got missed by the ACA. Sad.

They still might, depending on their income and the policy cost. It would be worth checking into for them.

[Spartana]

They still might, depending on their income and the policy cost. It would be worth checking into for them.
That's good to know. I think this was one of the issues Walmart employees were striking over - low income workers who had to pay too much towards their employers health insurance - especially if people making 4 or 5 times their income can qualify for subsidies to pay for health insurance,

[try2bfrugal]

That's good to know. I think this was one of the issues Walmart employees were striking over - low income workers who had to pay too much towards their employers health insurance.

This is why Trader Joe's stopped offering part-time employees health insurance - because they could get better coverage for lower cost on the exchanges than TJs could offer them, as long as they were not covered under an employer policy. TJs did them a favor and still gave them some money to subsidize the cost of an exchange policy.

I feel bad that TJs got bad press out of it when they were trying to do the right thing.

[gimmethesimplelife]

This is why Trader Joe's stopped offering part-time employees health insurance - because they could get better coverage for lower cost on the exchanges than TJs could offer them, as long as they were not covered under an employer policy. TJs did them a favor and still gave them some money to subsidize the cost of an exchange policy.

I feel bad that TJs got bad press out of it when they were trying to do the right thing.Yes, this! I think Trader Joes did the right thing too. Also - the few that work in restaurants that do have insurance usually have a mini-medical plan with something like 3K in coverage and that's it - a joke in other words. Employers that have such mini -policies really are doing their employees a favor by pushing them onto the exchanges. Rob

[Spartana]

If frugalone's employer stopped offering insurance like Trader Joe's did, she could get a better deal on the exchanges. Trader Joe's did their part time employees a favor by not offering them health insurance any more. Now most can get better, highly subsidized insurance on the exchanges, instead of the inferior policy that was the best TJ's could offer.
True but then you are shifting the insurance cost from wealthy private businesses onto the taxpayer's. Making big business even greater wealth and increasing taxes for citizens and the deficit. All on the back of higher earners who cannot use the subsidies themselves, but get to see their premium's sky rocket as well as their taxes. And as more companies stop offering insurance coverage to their employees - or eliminating full time jobs or reducing hours to p/t once the employer mandate kicks in - the greater that tax burden increases. Add into that that the potential millions who will retire a decade or 2 early because they can get subsidized health insurance, as well as the younger people who choose not to work or just work p/t, and you increase that national debt and the requirement for more taxes. All the while doing nothing to control health insurance costs which will probably continue to rise now that dear old uncle Sam I'd footing the bill rather than big business for many.

[ApatheticNoMore]

True but then you are shifting the insurance cost from wealthy private businesses onto the taxpayer's.

true but it's how every country does it, granted with healthcare systems that seem to control costs better, that is single payer. I do wonder if the policies the TJ workers get on the exchanges will be every bit comparable to those they had before (same deductable, same maximum out of pocket, same copays, same size network, with at least as many prestigious hospitals in it etc..) - because that, not just costs, is the comparison that actually has to be made, to evaluate the trade off. Not that non-unionized workers can necessarily complain much even if they got a bad deal.


All the while doing nothing to control health insurance costs which will probably continue to rise now that dear old uncle Sam I'd footing the bill rather than big business for many.

Don't know that big business had much negotiating power there, but yes there is nothing to stop costs from rising (I mean is there any strong negotiating power to cap costs like say hosptialization costs of pharma costs?). And uncle Sam plus the consumer will foot the bill.

[try2bfrugal]

True but then you are shifting the insurance cost from wealthy private businesses onto the taxpayer's. Making big business even greater wealth and increasing taxes for citizens and the deficit. All on the back of higher earners who cannot use the subsidies themselves, but get to see their premium's sky rocket as well as their taxes. And as more companies stop offering insurance coverage to their employees - or eliminating full time jobs or reducing hours to p/t once the employer mandate kicks in - the greater that tax burden increases. Add into that that the potential millions who will retire a decade or 2 early because they can get subsidized health insurance, as well as the younger people who choose not to work or just work p/t, and you increase that national debt and the requirement for more taxes. All the while doing nothing to control health insurance costs which will probably continue to rise now that dear old uncle Sam I'd footing the bill rather than big business for many.

Not all businesses are wealthy. In countries where the government is involved in providing medical care, health care costs are all lower than the U.S. All other countries, including those with universal and government supported health care have much lower health care costs than the U.S. Not a single country on planet Earth has higher health care costs than the U.S., though many have higher rated health care systems.

Check out these charts on health care costs in the U.S. compared to other countries -

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

Almost all other developed countries have some form of universal healthcare, many with more robust economies. Affordable health care isn't a failed social experiment. It is the way the rest of the develop world works.

[Spartana]

And luckily for you, you can now simply add the cost of your healthcare to my tab. Would it be out of place for me to ask that you exercise more and eat better, you know, positive steps to limit my liability?

Or maybe just mandate that people on medicaid look for a full time job - even a minimum wage job - in order to get medicaid. But Alan, it's time for you to come over to the dark side and dump your private health insurance and sign up for the low cost taxpayer supported VA like me. I may not believe it's right but I'll use it anyway :-) .Quit your job and become a poet like Bae.

[Spartana]

Actually can a person actually quit their job that has employer healthcare and sign up for the ACA or medicaid? I heard they couldn't but have never seen it written anywhere.

[Spartana]

Pretty much this kind of thinking that I am exhibiting here - this is very European kind of thinking and to a lesser degree Australian and New Zealand thinking - these countries have more of a "we" than a "me" mentality going on. I was about 12 wnen I decided for me personally it was going to be more "we" and not so much "me" - at least as far as basic human rights issues such as access to health care go. Rob
The difference is that healthcare is available to ALL people in those countries and ALL people pay taxes to support it. We don't have this with the ACA. I see this is highly discriminatory.

[Spartana]

Sadly, in FL it's not just income. My income is aboiut $500 a month but I have aqssets greate than $2,000 so I was turned down for Medicaid. For the foreseeable future I'll continue to not have access to jhealth care.
I be,sieve you can still apply for the subsidizes in states that don't have medicaid expansion and get all your medical insurance covered. That's what I read anyways.

[Spartana]

You still have never answered my question: So your point is that they are much better off with no health care and zero doctors than they are with free health care that includes some but not all doctors and hospitals as participating plan providers?
Well I'll answer :-) I personally feel that having medical care - even sub par or very basic care - is an absolute need for our society. I feel that it should be treated like public education - it may not be the greatest but even at a lower functioning level it is MUCH better to have in place.. Higher income earners can always opt for a private plan with more comprehensive care and access just like they do with private education. Of course I'm an advocate of universal or public healthcare for all just not a fan of obamacare - but better for some then nothing while worse for others.

[Spartana]

Not all businesses are wealthy. In countries where the government is involved in providing medical care, health care costs are all lower than the U.S. All other countries, including those with universal and government supported health care have much lower health care costs than the U.S. Not a single country on planet Earth has higher health care costs than the U.S., though many have higher rated health care systems.

Check out these charts on health care costs in the U.S. compared to other countries -

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

Almost all other developed countries have some form of universal healthcare, many with more robust economies. Affordable health care isn't a failed social experiment. It is the way the rest of the develop world works.
I agree. I think having universal care for all can be vastly less expensive. But we have a sort of a mish mash going on that leaves a lot of room for rampant increases for many as we see in the OP's original post. For example, the p/t people at TJ's, Home Depo, and other companies that are eliminating health insurance will be better off under the ACA yet their full time employees will be seeing some high cost increases.

[try2bfrugal]

I agree. I think having universal care for all can be vastly less expensive. But we have a sort of a mish mash going on that leaves a lot of room for rampant increases for many as we see in the OP's original post. For example, the p/t people at TJ's, Home Depo, and other companies that are eliminating health insurance will be better off under the ACA yet their full time employees will be seeing some high cost increases.

Why do you say the FT employees will be seeing cost increases because of the ACA? Health insurance rates have been increasing significantly every year lately, ACA or no ACA.

The Rand Corporation found that "While there have been some reports that the cost of individual policies may jump sharply under health reform, a RAND analysis of 10 states and the United States overall predicts that there will be no widespread premium increase in the individual health insurance market."

http://www.rand.org/news/press/2013/08/29/index1.html

[try2bfrugal]

Of course I'm an advocate of universal or public healthcare for all just not a fan of obamacare - but better for some then nothing while worse for others.

The issue is that there currently are no other choices. We can go forward or we can go backward on the health care front. The ACA provides insurance to 28 million people, most of whom are working adults or kids, with health insurance. It allows people with cancer to get insurance and health care even it they lost their jobs because they were too sick to work.

That cancer patient could be anyone of us, our parents or our kids next week or next year. I like knowing that I will always have health care whenever I might need it.

[try2bfrugal]

I be,sieve you can still apply for the subsidizes in states that don't have medicaid expansion and get all your medical insurance covered. That's what I read anyways.

Only if your income is above the Medicaid threshold levels. Otherwise Medicaid is not available in the states that opted out of Medicaid expansion. The federal government will pick up the tab for three years for Medicaid expansion, and 90% of the cost after that. There are few financial reasons for states not to expand Medicaid and help out their lowest income families. They are just playing politics with the health and lives of their lowest income earners at stake.

Related article on Medicaid Expansion -

http://www.webmd.com/health-insurance/20130716/states-struggling-with-medicaid-expansion

[iris lily]

[QUOTE=try2bfrugal;155802]... The federal government will pick up the tab for three years for Medicaid expansion, and 90% of the cost after that. ....

0% down! low low low monthly payments!

These offers and more huckster financial arrangements can be found on late night tv.

So let's see, I can pay one way or two ways: the feds pay (tax me once) or the states pay in addition (tax me twice.)

Win/win? or tax/tax?

[try2bfrugal]

0% down! low low low monthly payments!

This offer and other huckster financial arrangements cant be found on late night tv.

So let's see, I can pay one way or two ways: the feds pay (tax me once) or the states pay in addition (tax me twice.)

Win/win? or tax/tax?

Keep in mind, countries with government supported health care have much lower overall health care costs. It is how the rest of the developed world works. Insurance for all and many times over lower health care costs. Win / win.

Right now the winners in health care are the drug companies and the "non-profits" who are free to charge whatever they want with little controls. Have you read the Time article Bitter Pill?

http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,MedicalCostsDemandAndGreed.pdf

Right now health care in the U.S. is a lose / lose situation for the average tax payer.

"Taken as a whole, these powerful [health care] institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries.

Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries."

We spend twice the GDP of other countries on health care and yet still have 28 million uninsured. Guess where this money is going now? Hint it isn't the tax payers.

[ApatheticNoMore]

The Medicaid situation in California is so dire that a court case was literally filed to prevent Medicaid cuts and didn't suceed. So much for the plan of throwing everyone on Medicaid being likely to work.

"The 10 percent cuts to reimbursements for services under California’s Medicaid program, Medi-Cal, are set to begin phasing in next month, saving the state $387 million, but leaving many doctors and medical workers worried that there won’t be enough money left to take care of patients or themselves.

The cuts are intended to offset costs of Gov. Jerry Brown’s attempted expansion of Medi-Cal, while will offer Medicaid coverage to patients whose incomes are up to 138 percent of the federal poverty level. But in order to keep spending on Medi-Cal under control, the administration hopes is cutting 10 percent off each reimbursement."
http://www.medicaldaily.com/california-begin-phasing-disputed-medi-cal-reimbursement-cuts-medicaid-cuts-risk-patients-health

"The reductions to providers like Ma will also create a massive glitch in the implementation of national healthcare reform — the cuts to Medi-Cal rates are to occur just as more people prepare to join the program under the Affordable Care Act. Currently 8.3 million poor Californians are covered by Medi-Cal, and more than 1 million new enrollees are expected beginning next year

State officials argue the 10% decrease is necessary to keep healthcare spending under control, but medical providers fear it will devastate an already shrinking workforce and jeopardize patient care.

California has among the lowest Medicaid reimbursement rates in the nation, they say, and the reduction will lead to fewer doctors opting to see those patients. If that happens, California Medical Assn. President Paul Phinney said, many Medi-Cal recipients won't be able to find anyone willing to treat them"
http://articles.latimes.com/2013/jun/10/local/la-me-health-cuts-20130611

Yea everyone is going to go into Medicaid and happy times. Now it is possible that people exagerate the impacts of this (they all have their vested interests) and it's also quite possible the Medicaid situation could get very ugly in California. How much healthcare are people really going to get? I wouldn't want to be relying on Medicaid is what I'm saying.

[iris lily]

Keep in mind, countries with government supported health care have much lower overall health care costs. It is how the rest of the developed world works. Insurance for all and many times over lower health care costs. Win / win. .pdf[/URL]


[/FONT]

You are assuming a causal relationship between single payer gubmnt health care and low costs. And, it might be true--in other countries. But it may not be true. There are other factors in play there.

I do not believe for one moment that Americans will put up with anything other the the biggest and the best because it is now practically free at least for those who Nanny G has determined can't afford 9.5% of their income to go towards it. The taxpayers will pay for it, subsidize it if nothing else. We must have the total best for everyone, or people like Rob will whine some upper class dude will get better treatment, no matter if the dude has personal cash to pay for more advanced care. We all DESERVE advanced, state of the art care. It's our right. etc etc.

That don't come cheap.

[ApatheticNoMore]

You are assuming a causal relationship between single payer gubmnt health care and low costs. And, it might be true--in other countries. But it may not be true. There are other factors in play there.

I figure it's mostly true because they crack down hard on excessive pricing. Well since the ACA contains no costs controls .... I also think that's the main problem they'd have implementing single payer here. The major costs centers (hospitals, pharma - and why do we pay several times the cost of medicine here?) will fight it.

[try2bfrugal]

You are assuming a causal relationship between single payer gubmnt health care and low costs. And, it might be true--in other countries. But it may not be true. There are other factors in play there.

I do not believe for one moment that Americans will put up with anything other the the biggest and the best because it is now practically free at least for those who Nanny G has determined can't afford 9.5% of their income to go towards it. The taxpayers will pay for it, subsidize it if nothing else. We must have the total best for everyone, or people like Rob will whine some upper class dude will get better treatment, no matter if the dude has personal cash to pay for more advanced care. We all DESERVE advanced, state of the art care. It's our right. etc etc.

That don't come cheap.

There are many ways other countries work to constraint health care costs -
http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html

Almost all other developed countries see health care as a basic human right, like police protection and public school education. I understand you don't, that it is better to let lower income people die from treatable diseases like cancer and diabetes than to provide tax payer money to help for care. I don't know what to tell you except that is not the way the world works in other almost all other developed countries, and not how many people in the U.S. want it to work here either.

I think once the ACA is in and people see the benefits, there will be more support -
http://www.theatlantic.com/health/archive/2013/10/some-americans-say-they-support-the-affordable-care-act-but-not-obamacare/280165/

[try2bfrugal]

We all DESERVE advanced, state of the art care. It's our right. etc etc.

I do agree with you completely on that point. Have you seen the UK version of Breaking Bad (http://www.buzzfeed.com/lukelewis/if-breaking-bad-had-been-set-in-the-uk)? The doctor in the comic says what kind of barbaric society would allow medical care to hinge on a person's wealth? The vast majority of the developed world views health care as basic human right.

[gimmethesimplelife]

The difference is that healthcare is available to ALL people in those countries and ALL people pay taxes to support it. We don't have this with the ACA. I see this is highly discriminatory.Spartana, I have often said how much I appreciate your reactions to my posts as you often make me think. Once again you have made me think and BINGO - I think you have a very valid point here. As I have posted elsewhere in these health care threads we have going now, it looks like I will be on Medicaid to start with come January 1st and from what I understand it's going to be a freebie except for extremely minimal copays on visits and meds. Do I like this? Of course. Is it fair? 50/50 on that one. Honestly, I think there should be some kind of work requirement involved, even if it is something akin to volunteering at a food bank 25 hours a week or planting trees somewhere or collecting trash from the side of the road - it is not unfair for some kind of requirement to give something back to society. And this free Medicaid does not require this. LET THE CONSERVATIVES HERE NOT DROP DEAD OF SHOCK! I don't think it's right that since I am able bodied I should be handed this insurance with no strings. In Austria, where my mother's family is from, and a country I dearly wish the US was patterned on, there would be a requirement that I contribute somehow to society to justify the insurance. Even it were just 25 hours a week doing something brainless - some contribution to society somehow. I'm seriously thinking of volunteering at thrift shop at least a day a week to feel OK about having the insurance. Surprise to the conservatives out there! Rob

[gimmethesimplelife]

I do agree with you completely on that point. Have you seen the UK version of Breaking Bad (http://www.buzzfeed.com/lukelewis/if-breaking-bad-had-been-set-in-the-uk)? The doctor in the comic says what kind of barbaric society would allow medical care to hinge on a person's wealth? The vast majority of the developed world views health care as basic human right.As do I. Since the age of 12. This is one of the few stances I hold where I will not negotiate. As I have stated before, to me it's not my health care tab, or your health care tab, but OUR health care tab, as I see this as affecting the collective good of society. Rob

[gimmethesimplelife]

[QUOTE=try2bfrugal;155802]... The federal government will pick up the tab for three years for Medicaid expansion, and 90% of the cost after that. ....

0% down! low low low monthly payments!

This offer and other huckster financial arrangements cant be found on late night tv.

So let's see, I can pay one way or two ways: the feds pay (tax me once) or the states pay in addition (tax me twice.)

Win/win? or tax/tax?This is a big problem right here I have with America and I not blaming you IL. My experience in the US is that many think this way along the lines of what you have posted here.

My issue is thinking in terms of your own pocketbook over the collective good of society. But, people who think this way usually have not been exposed to something along the lines of Western Europe where everyone can tap into the perks at some time or other and there is no stigma involved in doing so. Since everyone can tap in at some point, there is not as much reason to think in terms of your own pocketbook as there is here as tapping in is not quite the same in the US.

I'm going to be 47 in November and I'm realizing how short our lives on this Earth are. This kind of thinking about your pocketbook above most else - is it worth the stress involved? To me the answer is a big NO. YMMV, I get that. Rob

[gimmethesimplelife]

One way I see to keep Medicaid costs down and quality reasonable? And I get that my idea is not going to happen.....it just isn't. I would have no problem with folks being sent to the safer border towns in Mexico for health care - especially for expensive procedures. My experience has been the quality of health care I have received in Mexico at border hospitals, at least in Mexicali, surpasses the quality I have received in the US those few periods of time in my life when I held private employer based insurance. Lots and lots of money could be saved doing this but it will never happen. There will be some not completely unfounded safety concerns, and it would be a public admission to the world that the US system doesn't work and the US is not going to make such a statement, not even to keep costs reasonable and line with what is possible and feasible. Rob

[iris lilies]

Actually can a person actually quit their job that has employer healthcare and sign up for the ACA or medicaid? I heard they couldn't but have never seen it written anywhere.

Why wouldn't someone who is unemplyed be able to signup for ACA mandated health insurance? It's required.

Maybe I am missing your question entirely.

[iris lilies]

One way I see to keep Medicaid costs down and quality reasonable? And I get that my idea is not going to happen.....it just isn't. I would have no problem with folks being sent to the safer border towns in Mexico for health care - especially for expensive procedures. My experience has been the quality of health care I have received in Mexico at border hospitals, at least in Mexicali, surpasses the quality I have received in the US those few periods of time in my life when I held private employer based insurance. Lots and lots of money could be saved doing this but it will never happen. There will be some not completely unfounded safety concerns, and it would be a public admission to the world that the US system doesn't work and the US is not going to make such a statement, not even to keep costs reasonable and line with what is possible and feasible. Rob

How about requiring that just those who receive health insurance with heavy subsidies,say, 50% and more are required to travel to Mexico for their care. What say you about that?

[gimmethesimplelife]

How about requiring that just those who receive health insurance with heavy subsidies,say, 50% and more are required to travel to Mexico for their care. What say you about that?Personally I'm OK with this. I have experienced high quality health care in Mexico that cost much less than it does on our side of the border. I can only imagine what kind of uproar there would be if this were actually put into practice, at least at first, due to the common American perceptions of Mexico, which are not 100% inaccurate. Like with anything else, you have to do the research and find the loopholes in the system. In this case, where is the quality cheap and high, combined with where is fairly safe to be about town in daylight? At the moment, Mexicali has all this to offer. I also understand that that could change though.....Of course there are cartels in Mexicali, they just have not had their turf challenged, so there is no reason there for the gore one now associates with most of the country. Another safe place is Tecate, not too far from San Diego, and also Los Algodones - but in Los Algodones you are limited to basic primary care doctors - for any procedures, they are just going to refer you to Mexicali. Rob

[iris lily]

I do agree with you completely on that point. Have you seen the UK version of Breaking Bad (http://www.buzzfeed.com/lukelewis/if-breaking-bad-had-been-set-in-the-uk)? The doctor in the comic says what kind of barbaric society would allow medical care to hinge on a person's wealth? The vast majority of the developed world views health care as basic human right.

I'm not sure what a cartoon character's musings prove. But I actually like the NHS model in the UK, the British are so civilized and sensible. NHS exists for the average Joe and then Harley Street physicians will serve those who don't want to stand shoulder to shoulder with the hoi poi. I, personally, would be content with NHS most likely. I'm a little less enamored of the Canadian system where there IS no opportunity for private treatment, well, unless you jump the border to the U.S.

The premise of Breaking Bad (U.S. Original) is that Walter White cannot afford, with his public employee health insurance, the state of the art treatment that his doctor recomends. I found that, and the latter version with Federal employee and brother-in-law Hank, preposterous. As if these public employees dhon't have insurance that's the best.

[gimmethesimplelife]

I'm not sure what a cartoon character's musings prove. But I actually like the NHS model in the UK, the British are so civilized and sensible. NHS exists for the average Joe and then Harley Street physicians will serve those who don't want to stand shoulder to shoulder with the hoi poi. I, personally, would be content with NHS most likely. I'm a little less enamored of the Canadian system where there IS no opportunity for private treatment, well, unless you jump the border to the U.S.

The premise of Breaking Bad (U.S. Original) is that Walter White cannot afford, with his public employee health insurance, the state of the art treatment that his doctor recomends. I found that, and the latter version with Federal employee and brother-in-law Hank, preposterous. As if these public employees dhon't have insurance that's the best.Something I find interesting about border Mexican health care - and you may find interesting too, IL - is that it is not all Americans going to Mexicali/Hermosillo/Tecate for health care - you will find Canadians in the mix too, who are unhappy with the waits for care and the quality is high and the prices are so amazingly low in these places for care - it's almost foolish in a way not to go for them. And remember, the prices that look so incredibly low to us - Mexicans pay even less - we pay more as the market will gratefully bear it. So they are grateful for us coming down as they are making good money on us, and we come out way ahead, too. It's win/win for most people. But I digress - my points was that yep some folks flee socialized medicine in Canada and opt for Mexico for health care, and I would agree this may say something about socialized medicine in Canada. Rob

[flowerseverywhere]

As do I. Since the age of 12. This is one of the few stances I hold where I will not negotiate. As I have stated before, to me it's not my health care tab, or your health care tab, but OUR health care tab, as I see this as affecting the collective good of society. Rob. But it really isn't our health care tab if you work hard for a good wage and pay high taxes as opposed too someone who works casually, gets free or subsidized health care, food stamps, free school lunch etc. As I have said before, growing up in foster care teaches you a lot. In another time or country I might have been a beggar or prostitute. I lucked out. The people who thought society owed them had a heck of a hard time. People who are thankful for everything they receive and work hard to contribute to society are whom I admire. I could have spent my life depending on social services I am proud to have pulled myself out of poverty. Safety nets are in place to give us a hand up when we are down. No one owes you anything in life. The ACA erases some of the problems, such as pre existing conditions. But somewhere people will be paying, either through premiums or taxes.

[gimmethesimplelife]

. But it really isn't our health care tab if you work hard for a good wage and pay high taxes as opposed too someone who works casually, gets free or subsidized health care, food stamps, free school lunch etc. As I have said before, growing up in foster care teaches you a lot. In another time or country I might have been a beggar or prostitute. I lucked out. The people who thought society owed them had a heck of a hard time. People who are thankful for everything they receive and work hard to contribute to society are whom I admire. I could have spent my life depending on social services I am proud to have pulled myself out of poverty. Safety nets are in place to give us a hand up when we are down. No one owes you anything in life. The ACA erases some of the problems, such as pre existing conditions. But somewhere people will be paying, either through premiums or taxes.And I don't disagree with you. My goal is to not spend much of my life on expanded Medicaid. I have started the enrollment process to go back to school full time here at Phoenix College - it is a local community college - to get a certificate in web development and design. My hope is to become self employed at some point and to no longer qualify for Medicaid and get my insurance from the exchanges - or who knows - maybe even not qualify for subsidies there at some point? We'll see. But I'm not considering expanded Medicaid a long term lifestyle, just insurance to bridge me until I can establish better income. Rob

PS Came back to add I still do see it as our tab.....this has not changed for me. But I also see it as my duty to better my lot in life so that my taxes can subsidize the next person in my current situation. This is what I mean by our tab. I don't mean a long term lifestyle of freebies - though OTOH were I in Western Europe, I would have much different views on this. I have had to take my thinking and alter it a little so that it has a chance to work somehow in this country. Rob

[try2bfrugal]

I'm not sure what a cartoon character's musings prove. But I actually like the NHS model in the UK, the British are so civilized and sensible. NHS exists for the average Joe and then Harley Street physicians will serve those who don't want to stand shoulder to shoulder with the hoi poi. I, personally, would be content with NHS most likely. I'm a little less enamored of the Canadian system where there IS no opportunity for private treatment, well, unless you jump the border to the U.S.

The premise of Breaking Bad (U.S. Original) is that Walter White cannot afford, with his public employee health insurance, the state of the art treatment that his doctor recomends. I found that, and the latter version with Federal employee and brother-in-law Hank, preposterous. As if these public employees dhon't have insurance that's the best.

The teachers in the public school district our kids went to do not have employer provided health insurance. None at all.

The cartoon is significant because it exemplifies the attitude difference in providing health care to all. People receiving tax payer funded government care aren't consider freeloaders in the UK. Everyone gets free health care regardless of ability to pay.

We know many people who rely on the UK public health care system, and their treatment overall seems very good. Few have ever had private insurance. They are generally very happy with their health care. They get free health care whether they are working or not, CEO or janitor. It is all tax payer funded. The last time WHO ranked health care systems by country, the UK was ranked 18th and the US 38th (for much higher cost).

[sweetana3]

No system is "perfect" with immediately accessible unlimited care for any and all issues.

Canadians or Americans who don't want to "wait" will always be able to secure whatever they want if they have enough money. UK//EU residents do the same thing.

I prefer to accept a system that is more accessible to all. I have friends of all ages in the UK and their care is generally excellent. They do have geographic differences but so do we (which will probably not change). Care in rural Mississippi is far different than care in a city with nine major hospitals and a medical school.

[IshbelRobertson]

Proud of our UK NHS, flaws and all!

The idea of not having universal healthcare as a right would frighten me to death!

[gimmethesimplelife]

Proud of our UK NHS, flaws and all!

The idea of not having universal healthcare as a right would frighten me to death!I've been frightened by this in the US for years! Rob

[iris lily]

The teachers in the public school district our kids went to do not have employer provided health insurance. None at all.

...

That's interesting, where is that?

[try2bfrugal]

That's interesting, where is that?

I am not going to give you my address, but you can read this -

http://www.insureme.com/health-insurance/health-insurance-for-teachers

"Now posing a dramatic and serious challenge for school districts across the country, health insurance is no longer a guaranteed financial benefit for teachers."

The teachers in our district gave up health insurance years ago in exchange for higher wages, before health insurance rates skyrocketed.

[iris lilies]

I am not going to give you my address, but you can read this -

http://www.insureme.com/health-insurance/health-insurance-for-teachers

"Now posing a dramatic and serious challenge for school districts across the country, health insurance is no longer a guaranteed financial benefit for teachers."

The teachers in our district gave up health insurance years ago in exchange for higher wages, before health insurance rates skyrocketed.

Address? General vicinity, especially city was all I was interested in, or even the state.

But never mind, Walter White and his cronies DO have health insurance package and a tidy one if I am to believe the website tool of the Albuquerque schools:

http://www.aps.edu/human-resources/benefits

That said, I lived in New Mexico and know how poor that state is, and it's likely that if any school districts are without health insurance, some of those would be in NM. Albuquerque would be one of the richer districts in the state.

[try2bfrugal]

That said, I lived in New Mexico and know how poor that state is, and it's likely that if any school districts are without health insurance, some of those would be in NM. Albuquerque would be one of the richer districts in the state.

Whether Walter White had or should have had insurance or not, it doesn't change the fact that millions of Americans are without any health insurance at all. The New York Times reported this number as 48 million (http://www.nytimes.com/2013/09/18/us/percentage-of-americans-lacking-health-coverage-falls-again.html?_r=0).

That is more uninsured in the U.S. than the entire population of Canada (48 million vs 35 million).

[gimmethesimplelife]

Whether Walter White had or should have had insurance or not, it doesn't change the fact that millions of Americans are without any health insurance at all. The New York Times reported this number as 48 million (http://www.nytimes.com/2013/09/18/us/percentage-of-americans-lacking-health-coverage-falls-again.html?_r=0).

That is more uninsured in the U.S. than the entire population of Canada (48 million vs 35 million).This has for years really gotten under my skin. Given that my mindset is more about the collective good of society, how do I forgive America for this? I don't know, I've never found a way to do so. I'm hoping that ObamaCare will be the vehicle that lets me drop this.....Rob

[Alan]

This has for years really gotten under my skin. Given that my mindset is more about the collective good of society, how do I forgive America for this?
Just out of curiosity Rob, what have you done all those years to provide for your own services other than to vote for whoever you thought would provide them for you?

If you cannot forgive America for not providing everything you want, how should America feel about your refusal to do the same?

[gimmethesimplelife]

Just out of curiosity Rob, what have you done all those years to provide for your own services other than to vote for whoever you thought would provide them for you?

If you cannot forgive America for not providing everything you want, how should America feel about your refusal to do the same?As I have posted time and time again, I see access to health care as a basic human right. Every other country in the developed world provides this and at a lower cost than our system in the US. What I have problems forgiving is that human life in the US has not been worth access to health care for so many - there is no structure, single payer, socialized, universal, whatever you want to call it - to provide this in the US. Until ObamaCare came along - and now we have a government shutdown as some folks in DC don't believe human life is worth access to health care. How does a thinking person that has comparison shopped their US citizenship against other countries citizenship forgive such a basic glaring lack? I have yet to ever run across anyone who could answer this question. Rob

[try2bfrugal]

Just out of curiosity Rob, what have you done all those years to provide for your own services other than to vote for whoever you thought would provide them for you?

If you cannot forgive America for not providing everything you want, how should America feel about your refusal to do the same?

So when 48 million people don't have health insurance, more people than the entire population of Canada, most of them working low income families, the sole reason as you see it is a lack of personal responsibility for all 48 million? Even though the majority do work, many are children, and one third don't have insurance because they lost their job (http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/)?

The answer is to just tell all 48 million to take more personal responsibility, and the problem would be solved? Does that mean the U.S. shouldn't have any waiters, fast food workers, farm workers or retail store workers because most of those jobs do not come with health insurance?

Alan, if you lost your job tomorrow would you have health insurance?

[gimmethesimplelife]

So when 48 million people don't have health insurance, more people than the entire population of Canada, most of them working low income families, the sole reason as you see it is a lack of personal responsibility for all 48 million? Even though the majority do work, many are children, and one third don't have insurance because they lost their job (http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/)?

The answer is to just tell all 48 million to take more personal responsibility, and the problem would be solved? Does that mean the U.S. shouldn't have any waiters, fast food workers, farm workers or retail store workers because most of those jobs do not come with health insurance?

Alan, if you lost your job tomorrow would you have health insurance?Very valid questions and points! Rob

[Alan]

So when 48 million people don't have health insurance, more people than the entire population of Canada, most of them working low income families, the sole reason as you see it is a lack of personal responsibility for all 48 million? Even though the majority do work, many are children, and one third don't have insurance because they lost their job (http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/)?


No, I was asking Rob specifically why he doesn't take personal responsibility for his desired services. He's told us hundreds of times how America doesn't work for him, I'm simply wondering if he feels a responsibility to work for America.
He's never given me any indication that his life circumstances are any different than mine or virtually everyone else I know, with all of us being able to care for ourselves and our families without suffering such severe disappointment with the rest of the country for not doing it for us.


Alan, if you lost your job tomorrow would you have health insurance?
Over the last 40 years I've done whatever it took to care for myself and my family and as a result have not lacked health coverage for a single day. If I lost my job tomorrow, I don't see that changing.

[gimmethesimplelife]

No, I was asking Rob specifically why he doesn't take personal responsibility for his desired services. He's told us hundreds of times how America doesn't work for him, I'm simply wondering if he feels a responsibility to work for America.
He's never given me any indication that his life circumstances are any different than mine or virtually everyone else I know, with all of us being able to care for ourselves and our families without suffering such severe disappointment with the rest of the country for not doing it for us.


Over the last 40 years I've done whatever it took to care for myself and my family and as a result have not lacked health coverage for a single day. If I lost my job tomorrow, I don't see that changing.Just curious Alan, have you priced an insurance policy pre-ObamaCare lately? Say you're one of the millions who have once held a decent paying job with benefits and now have to settle for nine dollars an hour with no benefits - you are supposed to afford health insurance how? I'm all ears as to your personal responsibility mantra works under these conditions.......Seems to me that under these conditions the most personally responsible thing you could do is to flee to a better country with socialized medicine and give up on the US altogether. Rob

[Alan]

.......Seems to me that under these conditions the most personally responsible thing you could do is to flee to a better country with socialized medicine and give up on the US altogether. Rob
To me, that seems less like personal responsibility and more like opportunism. We're probably just defining things differently.

I guess, to your point, if you're determined to transfer the cost of your services to someone else, another country might be a reasonable starting point, so, carry on.

[try2bfrugal]

Over the last 40 years I've done whatever it took to care for myself and my family and as a result have not lacked health coverage for a single day. If I lost my job tomorrow, I don't see that changing.

So without the ACA if you were unemployed and it took you a year to find a job, where would you get insurance from for that year and how much would it cost? Lets say your special needs grandson was living with you.

[Alan]

So without the ACA if you were unemployed and it took you a year to find a job, where would you get insurance from for that year and how much would it cost? Lets say your special needs grandson was living with you.
As a family, we have spent the vast majority of those 40 years with double coverage. Not being a seer, I can't give you specific answers to your what if's, I can only say that if our history is any indicator of our future, I'll be fine. Not because the government will be my savior, but because we've gotten into the habit of taking care of ourselves.

[try2bfrugal]

As a family, we have spent the vast majority of those 40 years with double coverage. Not being a seer, I can't give you specific answers to your what if's, I can only say that if our history is any indicator of our future, I'll be fine. Not because the government will be my savior, but because we've gotten into the habit of taking care of ourselves.

You don't have to be a seer. If you lost your job and your grandson was living with you, you wouldn't get family coverage for private pay because of pre-existing conditions. You could go on COBRA for 18 months, but it might cost you $1K to over $2 a month if you are 40+ and have a family. That is $12 - 24K for premiums alone for a year. Could you pay that easily?

Oops then you get into a car accident or develop cancer and can't work. You premiums are now $12 - $24K, you have a $10K out of pocket costs per year and your COBRA is running out. Now what? Time to take personal responsibility! Remember no running to the government for help.

Do you have some guarantee from God that nothing like this will ever happen to you or someone you care about?

I assume also you will be turning down your Medicare and SS benefits when you turn 65 because you don't want other taxpayers funding your retirement or health care in your old age.

[try2bfrugal]

Also you never answered my question on the 48 million in the U.S. without health care. Should we continue to let them all die of treatable diseases because they are low income? Should we do away with all the waiters, fast food workers, retail clerks and farm workers in the U.S. because they have jobs that don't have insurance? What is your solution?

Is lack of personal responsibility root the issue for all 48 million? Let's leave Rob out of this and just address the other 47,999,999 people in the U.S. without health insurance.

[ApatheticNoMore]

You don't have to be a seer. If you lost your job and your grandson was living with you, you wouldn't get family coverage for private pay because of pre-existing conditions. You could go on COBRA for 18 months, but it might cost you $1K to over $2 a month if you are 40+ and have a family. That is $12 - 24K for premiums alone for a year. Could you pay that easily?

well if you can't pay that easily you're up a creek anyway, because that's what rent costs every month. When I was unemployed health insurance was around $400 a month, of course rent continued to be a bit over $1000 a month. Now I could see that the problem is paying it AND rent, but rent would continue to be a larger concern for me.

[Alan]

Also you never answered my question on the 48 million in the U.S. without health care. Should we continue to let them all die of treatable diseases because they are low income? Should we do away with all the waiters, fast food workers, retail clerks and farm workers in the U.S. because they have jobs that don't have insurance? What is your solution?

Is lack of personal responsibility root the issue for all 48 million?
Of course, there are many, many reasons 48 million people don't have health insurance. Personal responsibility, or lack thereof, does come into play for a certain percentage of those. Isn't that the sole reason for the individual mandate in the ACA? To force people to do what they should have been doing all along.

[Alan]

I assume also you will be turning down your Medicare and SS benefits when you turn 65 because you don't want other taxpayers funding your retirement or health care in your old age.
Your assumption would be incorrect. I, along with my various employers, have diligently relinquished (through threat of force) a percentage of my compensation for over 40 years to ensure that I may possibly receive a stipend in my declining years. If I had been allowed a choice in the matter, I'm pretty sure I would have kept the money and came out way ahead through diligent investment and planning. Without that choice, I'll take the stipend if it's available. I say that I believe I'd come out way ahead because I've actually done quite well over the long term using portions of my compensation that the government allowed me to keep to fund our post employment life.

It hasn't been easy over the years, but in the end, assuming responsibility for yourself is so much more rewarding.

[try2bfrugal]

Of course, there are many, many reasons 48 million people don't have health insurance. Personal responsibility, or lack thereof, does come into play for a certain percentage of those. Isn't that the sole reason for the individual mandate in the ACA? To force people to do what they should have been doing all along.

Many people can't get insurance now. It is unaffordable or they have pre-existing conditions.

Are you in favor of laws that allow people with pre-existing conditions be allowed to purchase affordable insurance?

[Alan]

Many people can't get insurance now. It is unaffordable or they have pre-existing conditions.

Are you in favor of laws that allow people with pre-existing conditions be allowed to purchase affordable insurance?
Sure, but the entire concept of insurance involves assigning a cost to risk. The higher the risk, the higher the cost, so it's the definition of affordable that would come into play. Is there a formula for that which can be applied across the board without assigning the cost to others who may not be able to comfortably pay it?

[try2bfrugal]

Your assumption would be incorrect. I, along with my various employers, have diligently relinquished (through threat of force) a percentage of my compensation for over 40 years to ensure that I may possibly receive a stipend in my declining years. If I had been allowed a choice in the matter, I'm pretty sure I would have kept the money and came out way ahead through diligent investment and planning. Without that choice, I'll take the stipend if it's available. I say that I believe I'd come out way ahead because I've actually done quite well over the long term using portions of my compensation that the government allowed me to keep to fund our post employment life.

It hasn't been easy over the years, but in the end, assuming responsibility for yourself is so much more rewarding.

Social Security and Medicare are not one for one benefits. They are tax payer funded. You may get more or less back than what you put in. If you had a $1M medical bill, would you turn down your Medicare benefits because you wouldn't want to take money away from other tax payers?

[try2bfrugal]

Sure, but the entire concept of insurance involves assigning a cost to risk. The higher the risk, the higher the cost, so it's the definition of affordable that would come into play. Is there a formula for that which can be applied across the board without assigning the cost to others who may not be able to comfortably pay it?


Almost no one except the very wealthy without employer subsidized health insurance can comfortably pay for it now. Health insurance rates have been sky rocketing in the U.S. for years prior to the ACA.

Also see -

No widespread increase in cost of individual health insurance policies under the ACA (http://www.rand.org/news/press/2013/08/29/index1.html)

[Spartana]

Why do you say the FT employees will be seeing cost increases because of the ACA? Health insurance rates have been increasing significantly every year lately, ACA or no ACA.

This is what Home Depo said was going to happen to their full time employees - significant cost increases for their share of medical insurance. The 20,000 p/t workers will transistion to Obamacare. Walgreens will cut ALL medical insurance to All it employees and transition them to Obamacare. However they will give their f/t employees an aditional pre-tax amount to help pay for that. I believe that Alan said this is what will be happening the company he works for - dropping their good healthcare plan and transistioning employees to Obamacare with a monthly cash benefit amount (before taxes) to help pay for it.

From Rueters news: "Home Depot employs about 340,000 people and will continue to offer healthcare benefits to full-time employees, who will be paying more for that coverage next year due to higher healthcare costs", Holmes (spokesman for Home Depo) said.

Apparently 120 other large companoies are doing the same - sometimes for full time employees also.

[Spartana]

Keep in mind, countries with government supported health care have much lower overall health care costs. It is how the rest of the developed world works.
Most of those countries have a socialist twist to their economy and can control and regulate how much a private company can charge and how they do business. We don't do that here (and shouldn't imo).

I'd rather see an expanded version of a medicare-type of system for everyone. Flat taxes on everyone's income (like they currently have to pay for medicare for employed people), flat rate "affordable" monthly premiums that are not dependant on income or assets (like they currently have for medicare reciepients - lower income/asset people can be subsidied on a sliding scale), have HMO type cost shares with co-payments for services (like most medicare programs have) or do a PPO system with a percent of treatment payed for by the patient (like all medicare systems have now - again, low income/low asset people can get subsidized on a sliding scale), the govmint can act as a noin-profit insurance provider and contract out to medical facilities and Drs for care (like they currently do for medicare, medicaid, military Tricare and Champus, etc..), and private insurers can offer suplimental insurance or even complete alternative coverage (like medicare advantage programs currently do), and compete with government for a share of the health insurance business.

This will probably keep costs low like in other countries since people will have an option to go back to straight medicare-type system rather then pay ever increasing costs by non- government-contractor private insurers. And private insurers, knowing this, will be more likely to keep costs low. Yet the private insurers will still remain free to do business with minimal government interference or regulations on who and what they take and charge for services. You can eliminate the redundant systems like medicare, medicaid, the VA system, etc... That is what other countries do and that can keep costs alot lower for everyone because you are no longer holding people hostage with no choice but to accept the exorbitant price increases and all other bad things private insurers do. "Spartanacare?" - a free death panel for all :-)!

[Spartana]

Why wouldn't someone who is unemplyed be able to signup for ACA mandated health insurance? It's required.

Maybe I am missing your question entirely.I read somewhere "official" like somewhere in the "act" itself that if you voluntarily quit your job that has employer paid for insurance you can not go on Obamacare. If you are already unemployed or will be laid off you can. I also heard this on a radio show about the ACA. Don't know if that's true or not though. I also read something about how you can only sign up during the open enrollment period (which is until April 2014 I believe) and unless you life circumstances change - like a non-voluntary job loss - then you can't enroll until next open enrollment. I'll see if I can find out more (limited internet time for this Luddite ya know :-)!). I did download the Calif application and explanation out of curisoity after reading the OPs (Frugalone's) post here. So maybe something is written about it there. After reading it I can see how it is both very simple and very confusing for many people. Even myself, who would only qualify for medicaid and not the subsidies, got a bit confused. The plans don't look very good either. I had better coverage for a lot less with my barebones Blue Cross plan (that I have now dropped!).

[Spartana]

How about requiring that just those who receive health insurance with heavy subsidies,say, 50% and more are required to travel to Mexico for their care. What say you about that? Funny you mention this. I saw a tv show the other night that was about how employers are giving their employees the option for out-of-country medical care and operations rather than having them use their employer paid for medical insurance. This saved the employee several thousand in co-pays (they usually had no out-of-pocket costs), and saved the company increases in it's medical insurances plans, and the employers even gave the employees a $2500 bonus for using out-of-country medical services. The ones they showed had surguries in Costa Rica. Probably a new and growing trend amost employers.

[try2bfrugal]

Most of those countries have a socialist twist to their economy

By "those countries", you mean the ones with some form of universal care, which refers to almost all of the countries in the developed world other than the U.S.?

[dmc]

As I have posted time and time again, I see access to health care as a basic human right. Every other country in the developed world provides this and at a lower cost than our system in the US. What I have problems forgiving is that human life in the US has not been worth access to health care for so many - there is no structure, single payer, socialized, universal, whatever you want to call it - to provide this in the US. Until ObamaCare came along - and now we have a government shutdown as some folks in DC don't believe human life is worth access to health care. How does a thinking person that has comparison shopped their US citizenship against other countries citizenship forgive such a basic glaring lack? I have yet to ever run across anyone who could answer this question.
Rob

How does it work in Mexico, since you bring that up quite a lot? Does the government control the cost or do they just stay out of it. I really don't know.

It seams that the more the US government gets involved with a program the more things cost. Look at the cost of college.

[gimmethesimplelife]

How does it work in Mexico, since you bring that up quite a lot? Does the government control the cost or do they just stay out of it. I really don't know.

It seams that the more the US government gets involved with a program the more things cost. Look at the cost of college.Do you mean if you outsource your medical to Mexico for affordable access, or if you are a Mexican in the system? There a differences between these two scenarios, though I have once went to a Mexican free clinic - admittedly in Baja Norte which is one of the more prosperous states - and was very impressed. Rob

[iris lilies]

To me, that seems less like personal responsibility and more like opportunism. We're probably just defining things differently.

I guess, to your point, if you're determined to transfer the cost of your services to someone else, another country might be a reasonable starting point, so, carry on.

I haven't figured out where these countries with socialized medicine are that take in those who are fleeing there for the sole purpose of partaking of the socialized medicine.

Those countries tend to be very hard to get into. You've got to pretty much prove that you will not be a drain on their social services.

But everyone, good luck with that. If you find the way, let me know. I'd love to live in Yorkshire Eng or Vancouver Canada.

[ApatheticNoMore]

Hard to get into and then they kick out people who are obviously not a drain on their social services (Zoebird is coming back to us). And then if you get in, talk to people about how easy it is to get hired as an American in say Canada, it's not, even if you've got a professional skillset and it's a pretty good one.

Ever talked to people who were born in and have left those countries and don't want back? I have. Because America is so perfect and everything? No, they don't believe that, and they'd usually like a better social safety net in the U.S. - socialized medicine, more vacation, etc. but they see other things here, get used to it, etc. (plus I'm told a not insignificant factor is that the competition for professional jobs is worse some places than here - like everything else easier to deal with if you never get out of the habit of dealing with it).

Now if one wants to move to Latin America that they probably can do and there's nothing wrong with it, though I doubt it's for everyone.

[try2bfrugal]

Ever talked to people who were born in and have left those countries and don't want back? I have. Because America is so perfect and everything? No, they don't believe that, and they'd usually like a better social safety net in the U.S. - socialized medicine, more vacation, etc. but they see other things here, get used to it, etc. (plus I'm told a not insignificant factor is that the competition for professional jobs is worse some places than here - like everything else easier to deal with if you never get out of the habit of dealing with it).

Then again, you might be less likely to have talked to the people who did move back because they aren't here anymore to talk to. :)

The Atlantic has an interesting article on Why So Many Americans are Leaving the U.S. here:

http://www.theatlantic.com/magazine/archive/2013/07/americas-emigration-problem/309410/

Health care costs in the U.S. per capita are $8,232 vs $965 in Mexico, for fairly comparable average life expectancies.

[ApatheticNoMore]

Then again, you might be less likely to have talked to the people who did move back because they aren't here anymore to talk to.

I wasn't drawing a statistical conclusion*. But it is true, I don't know if I could easily get hired elsewhere, which is maybe the second most important thing (second to the people I care about here). Politics is further down than those.

* I was really just making the point that, contrary to popular belief, not everyone hates living here

[gimmethesimplelife]

Then again, you might be less likely to have talked to the people who did move back because they aren't here anymore to talk to. :)

The Atlantic has an interesting article on Why So Many Americans are Leaving the U.S. here:

http://www.theatlantic.com/magazine/archive/2013/07/americas-emigration-problem/309410/

Health care costs in the U.S. per capita are $8,232 vs $965 in Mexico, for fairly comparable average life expectancies.There are Americans leaving now for a wide variety of reasons - some due to the cost of living, stagnant wages, or my favorite - terror of American health care. I'm sure there are many other valid reasons. It is actually getting harder to legally get into a few South American countries I favor due to so many Americans with money and a great skill set trying to get in. Not something you are going to hear often on the US media but true nonetheless. If I had kids I'd sure be telling them it might be wisest to pack up and run.....Rob

There are also Americans, mostly younger, fleeing to Asia now as there is work for them there and health care is not a nightmare there in most of these countries. I have thought about this myself but the pace of life there and the overall dedication of life to the concept of work don't work for me. But for those who this works for that flee to Asia, more power to them, at least they are getting out of healthcare nightmares and debt per capita nightmares - with the exception of Japan.

[gimmethesimplelife]

I haven't figured out where these countries with socialized medicine are that take in those who are fleeing there for the sole purpose of partaking of the socialized medicine.

Those countries tend to be very hard to get into. You've got to pretty much prove that you will not be a drain on their social services.

But everyone, good luck with that. If you find the way, let me know. I'd love to live in Yorkshire Eng or Vancouver Canada.I'm thinking much more of South America - Chile and Uruguay especially strike me as interesting, especially Uruguay. There have been some interesting legal decisions in Uruguay lately - legal adoptions by gay parents, legal gay marriage, and legal marijuana (I don't partake but I think this US war on drugs is totally asinine). Rob Both have socialized medicine and in Uruguay it's only 20 years of work until you qualify for a pension - this is set in place as in Uruguay the mentality is that work is an evil necessity, why prolong it and let life pass you by? Truly my kind of thinking.....

[gimmethesimplelife]

I haven't figured out where these countries with socialized medicine are that take in those who are fleeing there for the sole purpose of partaking of the socialized medicine.

Those countries tend to be very hard to get into. You've got to pretty much prove that you will not be a drain on their social services.

But everyone, good luck with that. If you find the way, let me know. I'd love to live in Yorkshire Eng or Vancouver Canada.I would not be leaving just due health care, I have other issues too that I don't really go into here as health care for me is the biggie - knowing 24/7 how little human life is valued in the US due to the lack of accessible health care for all really does not inspire much confidence or faith in the citizenship. Which I have posted on ad nauseum by now. But I do have other reasons - another of which would be the American tendency to put work over everything else, and to have far too busy lives and take pride in this, or at least wear it as a badge of honor. I know not everybody here does this, some of us here don't for example and that's great. I'm talking about society as a whole. Also the American tendency to think in terms of "me" over "we" - I'll never get used to that and all the toxicity I see that causing. I have yet more reasons but these are the biggies. Rob

[iris lilies]

I'm thinking much more of South America - Chile and Uruguay especially strike me as interesting, especially Uruguay. There have been some interesting legal decisions in Uruguay lately - legal adoptions by gay parents, legal gay marriage, and legal marijuana (I don't partake but I think this US war on drugs is totally asinine). Rob Both have socialized medicine and in Uruguay it's only 20 years of work until you qualify for a pension - this is set in place as in Uruguay the mentality is that work is an evil necessity, why prolong it and let life pass you by? Truly my kind of thinking.....

While I'm not interested in the warm weather countries south of the border (can't grow anything that I want to grow there! ) I wonder what the entry requirements are for citizenship to grab those social programs?

I do really understand and admire a lifestyle that isn't devoted to 40+ hours of work for The Man, but I do not characterize the America I know as being that. You (the generic you) pick and choose your friends, your community, your society. If that's all that you experience, I say: find new friends, get the h*ll out of Dodge and move to another Dodge in another state. Personally, I find Phoenix to be one of the most ridiculous places on the planet-- conceptually. It's a megatropolis in the middle of the freakin' dessert. What a plastic, artificial place. But then, I love cities so it's not as though I am Miss Nature BackToTheWoods. I love real cities, old cities, the older the better and I have (illogical!) disdain for the new.

Am losing my point here except to say: The U.S. offers so much, how myoptic it is to generalize. I urge everyone to strike out and find "Your place" and "Your people." I've found it here in my city for 25 years, but I'm having a yen for something else. I'm very drawn to New Hampshire and the Libertarian movement there, that old Yankee Do It Yourself mindset, and the fascinating old houses and just the OLDNESS of the places. But am not drawn to more winter and shorter growing season.

Yet the perfect growing season, western Oregon would put me in with too many "progressive" citizens and I'd have to live in a 1960's ranch because I don't think there are any houses older than that (haha, a bit of a generalization.)

We are so fortunate in this country to have freedom of movement. Oh wait, I forgot, this thread is about How Bad Is America. Sometimes I can't keep on message.

[gimmethesimplelife]

While I'm not interested in the warm weather countries south of the border (can't grow anything that I want to grow there! ) I wonder what the entry requirements are for citizenship to grab those social programs?

I do really understand and admire a lifestyle that isn't devoted to 40+ hours of work for The Man, but I do not characterize the America I know as being that. You (the generic you) pick and choose your friends, your community, your society. If that's all that you experience, I say: find new friends, get the h*ll out of Dodge and move to another Dodge in another state. Personally, I find Phoenix to be one of the most ridiculous places on the planet-- conceptually. It's a megatropolis in the middle of the freakin' dessert. What a plastic, artificial place. But then, I love cities so it's not as though I am Miss Nature BackToTheWoods. I love real cities, old cities, the older the better and I have (illogical!) disdain for the new.

Am losing my point here except to say: The U.S. offers so much, how myoptic it is to generalize. I urge everyone to strike out and find "Your place" and "Your people." I've found it here in my city for 25 years, but I'm having a yen for something else. I'm very drawn to New Hampshire and the Libertarian movement there, that old Yankee Do It Yourself mindset, and the fascinating old houses and just the OLDNESS of the places. But am not drawn to more winter and shorter growing season.

Yet the perfect growing season, western Oregon would put me in with too many "progressive" citizens and I'd have to live in a 1960's ranch because I don't think there are any houses older than that (haha, a bit of a generalization.)

We are so fortunate in this country to have freedom of movement. Oh wait, I forgot, this thread is about How Bad Is America. Sometimes I can't keep on message.I will come back and post a long answer to your post later today or tomorrow, am kind of busy today. I did want to agree with you on one thing though - one thing that IS GREAT ABOUT AMERICA - yes, I did say that - is that you can have most any climate you want and all kinds of landscape/terrain. In Chile one can have some of this due to the dry deserts to the North and also due to the Andes. But somewhere really small like Uruguay - not so much. Better like the climate you move into there because you are stuck with it wherever you go.....You do have a great point here, IL. Rob

[Spartana]

Spartana, I have often said how much I appreciate your reactions to my posts as you often make me think. Once again you have made me think and BINGO - I think you have a very valid point here. As I have posted elsewhere in these health care threads we have going now, it looks like I will be on Medicaid to start with come January 1st and from what I understand it's going to be a freebie except for extremely minimal copays on visits and meds. Do I like this? Of course. Is it fair? 50/50 on that one. Honestly, I think there should be some kind of work requirement involved, even if it is something akin to volunteering at a food bank 25 hours a week or planting trees somewhere or collecting trash from the side of the road - it is not unfair for some kind of requirement to give something back to society. And this free Medicaid does not require this. LET THE CONSERVATIVES HERE NOT DROP DEAD OF SHOCK! I don't think it's right that since I am able bodied I should be handed this insurance with no strings. In Austria, where my mother's family is from, and a country I dearly wish the US was patterned on, there would be a requirement that I contribute somehow to society to justify the insurance. Even it were just 25 hours a week doing something brainless - some contribution to society somehow. I'm seriously thinking of volunteering at thrift shop at least a day a week to feel OK about having the insurance. Surprise to the conservatives out there! Rob Thanks Rob - I always appreciate your posts as well. You and I are pretty much on the same page as far as feeling that some sort of healthcare is needed for all. Including medicaid for the needy. And I have seen the most hardworking, frugal savers go from boom to bust and become destitute rapidly. A divorce, death of a spouse, illness, disability, loss of employment and bam - it can all be gone over night. So while I think medicaid should be for those who truelly aren't able to pay for healthcare themselves because of circumstances rather then choice, I believe it is much needed for those who can't work, or don't earn enough at their job - and are unable to find higher paying jobs -to buy affordable insurance. But I would like to see there be some incentives and regulations for healthily fit people who can work to get off medicaid. Be that job training or some kind of volunteer work while they are collecting medicaid and can get back on their feet.