Help with healthcare..

[3MTA3]

I love it, the freedom loving self reliant individualists planning to mooch on the hospitals and the tax payers in stead of carrying their load by paying for some insurance.

That's not what I was saying or advocating. Health insurance is one of the top priorities in my budget. I was pointing out that lack of insurance won't prevent you from getting emergency treatment.

 

[3MTA3]

So you're a fool around guns?

 

[MikeE]

Sorry, misunderstood you. I've been sitting in a hospital for two weeks so I have health care on the brain...

 

[PiratePast40]

... every ER is required by law to treat you, even if you can't pay.

Hearing that lame Rush Limbaugh crap from the Clinton era is really getting old. Try getting cancer or cardiac care at the ER. And by the way, the average wait time at the Salem hospital ER is now 4-6 hours.

Health insurance costs money. There is no way around it. For an idea on prices, for people that work for a living, my individual policy runs $587/month with a 3k deductible. And yes, rates go up every year, just like before O-Care.

 

[U201491]

Go in the Military do your time and get into the VA medical. It does not get better than what it is here in this area.
I should have signed on to it long ago, but took Kaiser instead for years. I heard so many stories about the VA and was afraid to use them. Sorry now I did that.
I never received such extremely great care than I have since signing on with it.
The hitch is you need to do your time in the service to get it.
Some areas the VA is terrible but not locally. It is the best care you can get.

 

[3MTA3]

Hearing that lame Rush Limbaugh crap from the Clinton era is really getting old. Try getting cancer or cardiac care at the ER. And by the way, the average wait time at the Salem hospital ER is now 4-6 hours.

It's called the Emergency Medical Treatment and Active Labor Act, and regardless of how you feel about Limbaugh it is the law. Waiting times are only going to get worse due to the govt meddling with the healthcare industry. The majority of people under 30 are pretty much forced to pay the penalty due to the cost of the healthcare.gov plans and rely on the ER.

 

[U201491]

Once it gets to single payer and a direct tax out of your check our health care will be the same as the veterans get, long lines and no care.

That is not true locally. Other areas yes, but not at the Portland VA. It does not get better than there.
They have a very close working relationship with OHSU and the care is beyond reproach.

 

[Bigfoot]

Thanks to zerocare big gov now has access to your bank and credit accounts in real time.

 

[forefathersrback]

unfortunately the message with insurance is they all suck. Though there are ones that suck more.

Avoid any of the medicaid plans if you can. CareOregon actively tries to kill my patients (literally, I'm serious here) and regular Medicaid is so overwhelmed you will only barely get emergency care. Medicaid now has a 2 month wait to get approval for a CT scan for example.

Most of the specialists are dumping Medicaid plans (cant blame them, hard to survive when you are getting paid 20% of you bill). So seeing certain specialists will take up to a year.

Out of the private insurances, Blue Cross is one of the worst right now. Very focused on making as much money as possible and they do it by making it as difficult as possible for patients to get what they need. Getting tests done like CT's will require fighting with a 3rd party company that has also told me that they would rather see my patient die than pay for a test.

Providence uses the same prior approval company, but they are a little better overall.

Not much in the way of problems with Moda. They are not on my crap list yet. You might try them.

Kaiser is its own beast. Going to be the least expensive usually but you are going to see a doctor that has to see twice as many people that I do in a day. I dont know how they expect you to "thrive" if your doctor can only spend 5 minutes with you. All of my wife's family uses Kaiser and I usually hear from them how much they suck on a regular basis.

Good luck. It all sucks right now (it all sucked before obamacare too, just a different kind of suck now)

If you want good healthcare, move to Canada!

Bolus; I hate to ask, however what are your thoughts, do you you think insurance coverage is going to get worse, or level off. {cost & coverage wise} Oh, yeah Za, I will checkout those new AK trigger kits! Thanks guys.

 

[jbett98]

I had Lifewise of Oregon for over twenty years.
Every year they raised my rates and I would then raise my deductible.
The last four years I was on their $10,000 deductible plan to save money, so instead of paying a higher premium, I paid myself the difference.
My way of thinking was that I'd rather take the gamble that I would stay healthy (which I did) and bank the savings then pay for something I didn't need.

 

[forefathersrback]

Our insurance 5 yrs ago was MODA. They rejected a neck surgery twice, due to tobacco use, even had to do a blood test for nicotine prior to surgery, so it was a no go! 4 yrs ago our insurance was changed to ODS, surgery was approved, no problems since. However they too have cut back on coverages, across the board. Heads up people. If you smoke,drink,cuss or do the hokey pokey, keep your mips sealed. Or you too could be denied.

 

[bolus]

Bolus; I hate to ask, however what are your thoughts, do you you think insurance coverage is going to get worse, or level off. {cost & coverage wise} Oh, yeah Za, I will checkout those new AK trigger kits! Thanks guys.

Oh, I gave up hope on anything improving a long time ago. The last positive thing I've saw is when HMO's imploded.

Hard to be optimistic when I get screwed over by my own insurance. The hospital system I work for has its own self managed medical insurance. I've had to threaten to quit 3 times to get insurance problems worked out. I have the guy in HR that manages benefits on speed dial and I dont even bother calling the insurance customer support side anymore when they mess something up.

 

[forefathersrback]

bolus; Thanks for your reply. Sounds like you are very proactive when it comes to your health Ins. Which we all should be.

 

[Member 5605]

Make no mistake: health insurance =/ healthcare

Here is something a well rounded friend wrote, I'm sure you will see.. Sorry I can't contribute to this conversation other than to say we are screwed either way. I'm cringing at how much we will be taxed next year on our "cadillac plan" so that another person I know will keep getting free care because he makes $19K a year, and get's $350/month in food stamps while getting a $10K tax return....

Thought I would post my thoughts on health care today. I noted this in remarks in a friends post, but felt compelled to share it here.

We have NEVER needed a new national health care plan, we just needed to mount fair rules within the private plans we had in place requiring them to compete and play fair so all could participate. We have been under attack with huge rising health care costs, but we did not focus on what is the best method of restructuring and we did not maintain our governing constitutional principles of free enterprise. Medicare (for all of us who have paid into it and who qualify usually 62-) and Medicaid (state ran and usually for those that qualify for this need based on income) required restructuring also, but they were federally subsidized programs offering competitive health care programs. By the way, where are all the monies I paid into those programs at??

Today more Americans have health care than ever before because they have been FORCED to have it. Not because they chose to.

Here's the facts for 2014:
You'll pay the higher of either 1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

Or $95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

The greater of either.

Here's the facts for 2015:
You'll pay either 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

Or $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.

The greater of either.

Here's the facts for 2016:
The penalty increases every year. In 2016 it's 2.5% of income or $695 per person. After that it's adjusted for inflation.

Those believing the new national health care system that is now in place is appropriate, do not understand modern tax law and miss the real reason it evolved. It is not free.

Our country was evolved out of a stiff free enterprise competitive financial development that forced the need for exacting health care for large populations to the smallest community doctor. All was primarily paid for through private development. With the dominance of an aging workforce in the US, we needed to focus on the development of health care a we did a poor job with the simple applications of Medicare and Medicaid without all the real costs being recognized or controlled.

Germany developed a highly government controlled healthcare system based on its principles under solidarity, subsidiarity, and corporatism where they control all health care development to the local level while taxing the public at 15%+ and making specialists Drs a thing of the past allowing generalists Drs to play the leading role. Those making $50k or less participate in the statutory health insurance scheme (STI) funded by 150 sickness funds (SF) built under the taxation. They can keep it because it works for them. It is not free. I'm sorry that our media (specially the alphabet channels) pump this hypocrisy into those who will believe, but not so for me. It's not free.

I do not want the government operating all aspects of health care for me, as in Germany, voting in and out arbitrary rules that affect my need for health care. It's not right.

France is similar to what we have in the US, but they base their health care in solidarity, liberalism, and pluralism. Several elements of the French health system - the predominance of office-based medical practice, the mix of private and public hospitals, the use of patient cost sharing, direct payment of physicians by patients, and financing derived from payroll taxes assimilates our health care system, yet it is still originating from government controlled taxation. Not free enterprise. They can keep it too. It is not free.

I want to choose care based on my own evaluation of need and price of care. I do want regulations on price gouging, say for ambulatory needs or hospital emergency care or long term stays, but not on any health care provider (less rules on gouging for services and give aways) and certainly the insured should never be "fined" or "imprisoned" for not using national health care. That is not free.

The fact here is that no health insurance or coverage is free and never has it been. Somebody has to pay for it. The reality is that free enterprise in all sectors of our working society, with appropriate rules in place, leads to the highest quality, most competing and affordable businesses including health care for infants through end of life. That is something I'll pay for and has been proven to drive costs down.

Considering that there are are over $500 billion dollars of new tax hikes embedded in the Patient Protection and Affordable Care Act, and the defining reason for its passage has not been addressed, then a reasonable person might conclude that the real purpose of the bill was more to raise taxes than to provide affordable Health Insurance and Health Care to the People.

We as Americans must remember that the only power government officials have is the power to exact funds (taxes) by force (tax laws) and distribute those funds according to their will and philosophy and that power under Our Constitution is delegated to them by Us. Perhaps Thomas Jefferson said it best:

"To compel a man to furnish funds for the propagation of ideas he disbelieves and abhors is sinful and tyrannical."

Our country of ~320,000,000 people is being ran by 535 members of Congress, 9 members of Supreme Court, and 1 President a total of 545 people. We MUST make some changes or President Jefferson will be absolutely correct.

-Nathan

 

[mkwerx]

Last year we had Moda. Paid something like $3600 with nary a doctor visit. They wanted to jack my rates. I already felt ripped off thanks to the government mandated crap coverage - even with "them" paying for part of the coverage. Rip off tax payers, rip off healthcare patients. Someone is profiting from the deal, but it isn't the average consumer.

We opted for the cheapest plan this year - bronze plan from Oregon Health Co Op. $115 a month for family coverage after the "subsidy" (no, I'm not proud to have taken it, but I'm not going to drop $500 a month on identical, crap coverage) - there wasn't a lot of difference between th silve and bronze plans we could see, to justify the extra $200 a month for the silver plan. Out of pockets were roughly the same, except silver had a few more things covered and slightly better scrip coverage.

That BS line that the feds kept beating "Sign up by December 15 for coverage on January 1" - complete crap. We signed up on December 6th - only to find out our new insurance policy would not kick into effect until February 1. Our Moda policy expired on Dec 31. On January 10th, I had to take my wife to the ER for severe abdominal pain. It wasn't our first choice - we went into one of those cash-friendly urgent care clinics, the doctor did a cursory exam, asked some questions, then said "you need to get out of here and get to an ER, we don't have the imaging equipment needed to diagnose abdominal problems. We're not charging you for this visit but get to the ER now" - so we went. 4 hours in St. Vincent ER later (I hate that particular hospital with a passion, but that's a rant for another time) my wife was given a scrip for priolosec and told if it doesn't help, or things get worse, call her regular doctor.

The ER folks took blood and urine, but never ordered any imaging tests. The ER doc said he didn't think it was an infection, didn't think it was her appendix (pain in the wrong place) but didn't know what it was.

She's been living in pain for over a month now, with no frickin idea what's wrong. We scheduled her an appointment as soon as they could fit her in her regular doc's office after our insurance kicked in, which was a week ago. He did an exam, his ultrasound wasn't good enough to get the images he wanted, so he made an appointment with a clinic that does nothing but medical imaging. We're waiting to hear back from her doctor the results of the ultrasound - lab tech said it could be a day or two before he's had a chance to look at the video/pictures and get back to us.

ER visit to St V wasn't cheap, but Oregon Health Co Op might be covering part of it, since our policy took effect within 30 days of her visit there. Moda flat out told us to pound sand when we asked if they could do anything. The Healthcare.gov ads are full of excrement. The ACA is bad law, congress knew it (those that bothered to read it or the TLR version), Obama knew it - but they foisted it upon us anyway.

I could've saved that $3600 last year and paid for the ER visit, a doctor's visit, and the ultrasound clinic in cash - for all the good it did. Or maybe my wife wouldn't have gotten sick, and that money could be going to moving expenses this year, down payment on a house, or a newer cheap car that does better fuel than my 1990 Suburban. Could also have purchased 3 Ruger SR556 rifles, or 4 S&W M&P15 Sporter models, 6 new Glock gen 4 handguns...

I'm not bitter in the slightest though

 

[Caveman Jim]

Almost as bad or worse than car insurance, no claims but it goes up every year!!!!!
House ins as friggin bad too!!!!
At any rate it's getting to the point where I have to put off gun purchases due to something came up & gobbled up that little nest egg I had been nurturing....

 

[U201491]

Almost as bad or worse than car insurance, no claims but it goes up every year!!!!!
House ins as friggin bad too!!!!
At any rate it's getting to the point where I have to put off gun purchases due to something came up & gobbled up that little nest egg I had been nurturing....

We pretty much just resort to barter and trade anymore.

 

[Bigfoot]

We pretty much just resort to barter and trade anymore.

That is a an alternative. Take that $6G per year and deposit it, when you need care health providers are more that happy to give significant discounts for patients paying with cash, saves em untold paperwork with insurance companies and now fedzilla interfering telling them what and how to provide care.

Combine that with an inexpensive catastrophic policy. IF the feds still allows us to purchase them.

 

[U201491]

That is a an alternative. Take that $6G per year and deposit it, when you need care health providers are more that happy to give significant discounts for patients paying with cash, saves em untold paperwork with insurance companies and now fedzilla interfering telling them what and how to provide care.

Combine that with an inexpensive catastrophic policy. IF the feds still allows us to purchase them.

???? That was in response to CavemanJims comment.
I was talking about buying everything else. There is no money for buying anymore.
We try to barter and trade of about anything that we need.
It works.

As for insurance and medical coverage. Even the best can't account for paying the bills with a major medical problem that put ya down for several months and by that I mean all the normal bills/expenses to live when you also do not have any income during that OFF/Down time. Most folks seldom think about that part of it. Getting the medical bills paid is just a part of the issue.
Great care, and good medical coverage still doesn't pay all the rest of the bills.
When you have bad coverage, it just magnifies the problems even more.

.

 

[44mag2ndamend]

E.T.

I am not alone