Medicare

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Rule62

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When I went on medicare I chose an 'Advantage Plan' and quickly found out that the Advantage was no dr would take it. Being a relatively healthy sort I was able to ride out the first year and switch back to medicare Pt B and a F medicare suppliment. So my net out of pocket was about $150 per mo, plus I had drug coverage as well.
Here in the DFW area the Ovomit plans have all gone to HMO/EPO which I have no experience at all with. So I'm waiting to see if my G-sons new HMO is just another 'Advantage Plan'.

I researched it carefully, back when I first signed up, and re check every year. So far, for my needs, I've been happy with the AARP/UHC Supplimental.
 

EBates

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Yeah, I have mine through BSBC and it's been great. my wife has a prescription or two that we have a co-pay of ~$100 but other than that it's been all good.
The Ovomit plans are the only ones I'm worried about since neither BSBC/UHC et al offer a PPO and the deductables are nearly $4k for them.

OBTW I guess you've heard UHC is planning to dump Ovomit plans. Might be just talk but FYI.
 

oplholik

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Yeah, I have mine through BSBC and it's been great. my wife has a prescription or two that we have a co-pay of ~$100 but other than that it's been all good.
The Ovomit plans are the only ones I'm worried about since neither BSBC/UHC et al offer a PPO and the deductables are nearly $4k for them.

OBTW I guess you've heard UHC is planning to dump Ovomit plans. Might be just talk but FYI.

Don't know how it will actually turn out, but I read an article a few weeks ago, never be able to find it now to back this up but, the article stated that the govt. was wanting to "quietly" subsidize these insurance companies to keep them in. Wouldn't surprise me in the least.

The wife and I have been on Medicare with an advantage plan for a few years now, an HMO plan, and it is better than anything we ever had while working. At this time I think we are paying $100 a month each. We both go to the same medical clinic, and they have excellent doctors. We have been very pleased with it. I have had a couple fairly serious issues, and have been well taken of.
 

schatz

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Just went on Disability and 2yrs to qualify for Medicare:( In a hole until then. My Co insurance will jump from $327 to $1196 in about 2 months. Needless to say - Cannot afford that!:-x
Glad to hear Medicare is pretty decent. Should be able to handle a single policy for the wife.
My wife has been disabled for 4 years, finally just got her on medicare and it is much cheaper, your going to love it. Just for me and my 2 kids its over 900. They are really trying to screw the middle class with this one. The only thing good to come out of this health care reform, was doing away with preexisting condition exclusion. My wife had cancer in 2004 when she was 40 and could not find insurance outside of agroup policy.
 
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englishmick

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Should you ever want to see medical costs drop like a rock, eliminate all third party payers. As long as someone else pays the bills, the bills will remain high.

Right. The insurance companies steal 32c out of every dollar we pay for medical care. Which pretty much accounts for the difference between the cost of American health care and everyone else in the civilized world. In exchange they give us the most complex and dysfunctional bureaucracy ever devised by the human race. Only the American government does less with more.

I read once that year by year the American health insurance scam grabs more money than all organized crime in the entire world put together, including drugs, guns, human trafficking, and a few others that slip my mind.
 

CMD-Ky

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There was a time when the doctor's parking lot was populated with Fords and Chevy's and being physician was a middle class profession. A hospital "administrator's" office was a small simply furnished room. A hospital lobby was an unadorned entry way into the elevator hall. There were no Jacuzzis or tempurpedic mattresses. The number of people in white uniforms outnumbered those in business clothes. When it comes to the disbursement of your health care dollar, there are plenty of taker's with very greedy irresponsible hands. This time described could have been widely found as late as the early 1980's.

I am not an apologist for insurance companies; I am, however, an advocate for a realistic analysis of health care financing and the allocation of the money committed to care. To see insurance companies as the only or even as the primary abuser of the health care dollar is too narrow a focus.

[If you read that the health insurance "scam" takes in more money than organized crime then you read a lie.]

Right. The insurance companies steal 32c out of every dollar we pay for medical care. Which pretty much accounts for the difference between the cost of American health care and everyone else in the civilized world. In exchange they give us the most complex and dysfunctional bureaucracy ever devised by the human race. Only the American government does less with more.

I read once that year by year the American health insurance scam grabs more money than all organized crime in the entire world put together, including drugs, guns, human trafficking, and a few others that slip my mind.
 
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papergoblin

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I hope the Medicare works better than the Medicaid, I have a son that is special needs and I take care of him full time. I qualified for Medicaid, costs aren't bad but needed and urgent care today actually and no one accepts it. I decided to deal with the pain (tooth abcess- however it is spelt) instead of running to the ER. It sucks, all I need is an antibiotic but can't get one without the er, as with an adult Medicaid doesn't cover dental and it's the weekend.
 

papergoblin

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There was a time when the doctor's parking lot was populated with Fords and Chevy's and being physician was a middle class profession. A hospital "administrator's" office was a small simply furnished room. A hospital lobby was an unadorned entry way into the elevator hall. There were no Jacuzzis or tempurpedic mattresses. The number of people in white uniforms outnumbered those in business clothes. When it comes to the disbursement of your health care dollar, there are plenty of taker's with very greedy irresponsible hands. This time described could have been widely found as late as the early 1980's.

I am not an apologist for insurance companies; I am, however, an advocate for a realistic analysis of health care financing and the allocation of the money committed to care. To see insurance companies as the only or even as the primary abuser of the health care dollar is too narrow a focus.

[If you read that the health insurance "scam" takes in more money than organized crime then you read a lie.]

Actually the insurance group and the care facilities get together and create a contract. This contract of pay for what is how deductibles are determined. Look into Arizona, when the national health care started a group in one county had a deductible of say $100 a month, one county over for the same plan was $200. Interstate insurance coverage is the only way to fix this system, you take Alabama for example, you want decent insurance you have to have Blue Cross Blue Shield. They have a monopoly on the state and the gov. allows it, all the while saying monopolies are illegal. Here's a better idea yet, allow consumers to pay insurance prices. My uncle with insurance had an MRI he paid $300 his deductible, the insurance paid the rest $2.50. How's that work out right when he pays $700 a month for him and my aunt (homemaker) just to have a $3500 deductible a piece and that is with a gov. sub.
 
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schatz

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There was a time when the doctor's parking lot was populated with Fords and Chevy's and being physician was a middle class profession. A hospital "administrator's" office was a small simply furnished room. A hospital lobby was an unadorned entry way into the elevator hall. There were no Jacuzzis or tempurpedic mattresses. The number of people in white uniforms outnumbered those in business clothes. When it comes to the disbursement of your health care dollar, there are plenty of taker's with very greedy irresponsible hands. This time described could have been widely found as late as the early 1980's.

I am not an apologist for insurance companies; I am, however, an advocate for a realistic analysis of health care financing and the allocation of the money committed to care. To see insurance companies as the only or even as the primary abuser of the health care dollar is too narrow a focus.

[If you read that the health insurance "scam" takes in more money than organized crime then you read a lie.][ docs.
 

schatz

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[Q
Oh, come on. Can you address the post or are you limited to personal attack?

UOTE="CMD-Ky, post: 17008991, member: 159273"]Oh, come on. Can you address the post or are you limited to personal attack?[/QUOTE]
Oh, come on. Can you address the post or are you limited to personal attack?
You are right, I guess opened a beer a little early today. Sorry, I apologize.
 
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CMD-Ky

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Well, you have given me a great idea, I'm off to the refridgerator. (If I could spell refrigerator.)

[Q


UOTE="CMD-Ky, post: 17008991, member: 159273"]Oh, come on. Can you address the post or are you limited to personal attack?

You are right, I guess opened a beer a little early today. Sorry, I apologize.[/QUOTE]
 

schatz

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Glad I could be of service.
There are times when I need a push in the right direction and I appreciate it.[/QUOTE]
I hear you, I get passionate about medical stuff, especially when drinking. I want to apologize again, but now I have to go get another beer and stay away from the forum for a while.
 
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englishmick

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There was a time when the doctor's parking lot was populated with Fords and Chevy's and being physician was a middle class profession. A hospital "administrator's" office was a small simply furnished room. A hospital lobby was an unadorned entry way into the elevator hall. There were no Jacuzzis or tempurpedic mattresses. The number of people in white uniforms outnumbered those in business clothes. When it comes to the disbursement of your health care dollar, there are plenty of taker's with very greedy irresponsible hands. This time described could have been widely found as late as the early 1980's.

I am not an apologist for insurance companies; I am, however, an advocate for a realistic analysis of health care financing and the allocation of the money committed to care. To see insurance companies as the only or even as the primary abuser of the health care dollar is too narrow a focus.

[If you read that the health insurance "scam" takes in more money than organized crime then you read a lie.]

Yeah, you're right. I happened to be particularly mad at the insurance companies right now. They are just part of the problem and I don't know how big a part. Drug prices are another element. My doctor's place of work is like an office complex with a few doctors and nurses stuck away round the back.

As for insurance costs, I found this.

"In 2014, U.S. health care spending increased 5.3 percent following growth of 2.9 percent in 2013 to reach $3.0 trillion, or $9,523 per person. The faster growth experienced in 2014 was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance. The share of the economy devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. "

My recollection is that insurance takes around 32% off the top, including the cost of the clerical services on the medical care side. If that's correct which I don't have any evidence for, then insurance is pulling in around 1 trillion a year. That's a lot of money, and based on the para I posted above it would come to 6% of the American economy. I've read that admin costs in Europe and elsewhere are typically around 5%. Some of my numbers may be off but whatever it's still a huge pile of dosh.
 

englishmick

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As for insurance costs, I found this.

"In 2014, U.S. health care spending increased 5.3 percent following growth of 2.9 percent in 2013 to reach $3.0 trillion, or $9,523 per person. The faster growth experienced in 2014 was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance. The share of the economy devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. "

My recollection is that insurance takes around 32% off the top, including the cost of the clerical services on the medical care side. If that's correct which I don't have any evidence for, then insurance is pulling in around 1 trillion a year. That's a lot of money, and based on the para I posted above it would come to 6% of the American economy. I've read that admin costs in Europe and elsewhere are typically around 5%. Some of my numbers may be off but whatever it's still a huge pile of dosh.

Quoting myself here to update my previous post.

I found this on the subject of organized crime.

"The annual turnover of transnational organized criminal activities such as drug trafficking, counterfeiting, illegal arms trade and the smuggling of immigrants is estimated at around $870 billion, the UN Office for Drugs and Crime (UNODC) said."

If my calculations above were correct then this, $870 billion, is a little less than the $1 trillion the medical insurance industry costs the American economy every year.

However that's the Health Insurance Costs For Dummies version. I found some more rigorous academic analysis that provided a different and presumably more accurate picture. They factored in a lot of detail. For example the fact that American doctors spend an average of 58 minutes a day on insurance related tasks. And the overhead of insurance companies in isolation varied from 8% to 17%, not counting the assorted costs of interfacing with them. And differences between family doctor practices and hospitals etc. After a bunch of number crunching they came up with an actual annual cost of using the insurance industry to control the provision of health care of between $340b and $480b.

They gave some explanation for the large spread in the results. It depends partly on what you count. Do you count the cost of paying doctors for an hour a day of insurance work. Do you count the cost of the HR time companies put in. The cost of all the lawyers on both sides beavering away arguing about disputed insurance claims. I even found a number of hours the average citizen spent per year dealing with insurance and an estimate of how much that could be said to cost the country. I saw final numbers in several other places ranging from $280b to $620b.

That total includes Medicare, which has far lower administrative overheads, and ACA, which has higher than average overheads.

So they are only taking in around half as much as world organized crime instead of more as I previously claimed. Of course those other criminal groups actually provide a service to their customers. Like they give them drugs and guns. Not sure what I get from health insurance, other than a gigantic headache.
 

petrotech

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So they are only taking in around half as much as world organized crime instead of more as I previously claimed. Of course those other criminal groups actually provide a service to their customers. Like they give them drugs and guns. Not sure what I get from health insurance, other than a gigantic headache.

:lol::lol::lol:
 
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