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Discussion Starter #1 (Edited)
I heard today that somewhere near 30 million people in the US don't have health insurance. A quick and dirty calculation show ~ 90% of people have some form of health insurance. Is 10% of the population without health insurance enough to get people excited about moving to "medicare for all" or some other nationalized system. Maybe these numbers are wrong.
 

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That number sounds about right based on articles I saw in a quick google search.

I think that part of the problem is not just people who do not have health insurance but also many people have very bad and expensive health insurance.

The number of uninsured has gone up. I'd like to see some data on why they are uninsured. Now that the mandate is not there and people aren't fined via the income tax filings, I can see some people dropping their insurance to save the money. A lot of younger people just don't bother with health insurance because they are healthy and feel like they don't need it.

What bothers me about the "Medicare for all" thing is that there is no real plan. I've seen Bernie's half baked plan for financing it. The plan leaves out a lot of details, very important details.

There is no explanation of that "Medicare for all" will cover. For example in Bernie's plan there are actually two medical plans... the current Medicare for the elderly and then the other Medicare (Medicare 2?) for everyone else. If the Medicare 2 pays at the same rate as the Medicare for the elderly, it's going to run hospitals, doctors and other medical providers out of business. It will put millions of people out of work.

We cannot make a sudden change in a huge industry like this. It should be done gradually, if at all.

For example, Medicaid could be expanded to cover anyone who wants to pay for. The premiums could be the same all over the country. The premiums would be based on income. So a low income person might get it free. But let others buy insurance or have it provided by their employers.

I just don't think that anyone running for office right now has a workable plan, or has even thought it all through.
 

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That number sounds about right based on articles I saw in a quick google search.

I think that part of the problem is not just people who do not have health insurance but also many people have very bad and expensive health insurance.

...
I agree. The problem is not just about those without. In addition to what Ele points out, there are people who worry about coverage like if they fear losing their jobs. People who have not had it in the past and it created worry or problems. People who have loved ones without it. Supplements are expensive for old people, etc.
 

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If the Medicare 2 pays at the same rate as the Medicare for the elderly, it's going to run hospitals, doctors and other medical providers out of business. It will put millions of people out of work.
Many doctors offices and a few hospitals here won't even take state Medicaid because they either get paid very late or only receive partial payments. Imagine this on a national scale.
 

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I would imagine there are many who think health insurance is not necessary. I work with a woman who thought that. She quit her job and moved to Florida. I asked her about health insurance and she scoffed, "that's ridiculous to worry about, I've never used mine, ever" Well, 2 months later she had a stroke at age 42 and ended up in the ICU for 2 weeks. I don't even want to know what that bill was. Of course, her plan is to ignore the bill. That means WE all will pay for it with rising medical care costs.

I'm sure there are many who would love to have insurance but simply can't afford it. I'm lucky to have very good health insurance. My job offers crappy insurance. My coworkers complain about it all the time. One ER visit can cost over $1000. I made sure my continued coverage by my exH was part of my divorce settlement. Not everyone is that lucky so to them, health insurance is a big deal during this election.
 

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I would imagine there are many who think health insurance is not necessary. I work with a woman who thought that. She quit her job and moved to Florida. I asked her about health insurance and she scoffed, "that's ridiculous to worry about, I've never used mine, ever" Well, 2 months later she had a stroke at age 42 and ended up in the ICU for 2 weeks. I don't even want to know what that bill was. Of course, her plan is to ignore the bill. That means WE all will pay for it with rising medical care costs.

I'm sure there are many who would love to have insurance but simply can't afford it. I'm lucky to have very good health insurance. My job offers crappy insurance. My coworkers complain about it all the time. One ER visit can cost over $1000. I made sure my continued coverage by my exH was part of my divorce settlement. Not everyone is that lucky so to them, health insurance is a big deal during this election.
A hospital offers crap health insurance? How ironic.
 

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A hospital offers crap health insurance? How ironic.
Health care is notorious for offering crap insurance. It's very ironic. In our case, our hospital has it set up so if you try to see anybody not associated with our hospital you pay through the nose. They'll "cover" a physician not employed by us but at about 20% of the actual bill so what's the point. A coworker recently had a medical emergency. The ambulance took her to the nearest hospital which is standard practice. She had a 2 day stay. She was billed almost $10K that the insurance didn't cover. When she called to dispute it they told her it was her own fault for "going outside our network" as if she had a choice in the matter. :surprise:

In contrast, I've had 3 major surgeries and another week long hospital stay in the last 3 years all at different hospitals, none of which was where I work. My insurance, through my husband's company, covered everything, soup to nuts. I didn't pay a dime for any of it. That's why I made sure he would continue to cover me and being a decent guy he wanted to do it too.
 

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Health care is notorious for offering crap insurance. It's very ironic. In our case, our hospital has it set up so if you try to see anybody not associated with our hospital you pay through the nose. They'll "cover" a physician not employed by us but at about 20% of the actual bill so what's the point. A coworker recently had a medical emergency. The ambulance took her to the nearest hospital which is standard practice. She had a 2 day stay. She was billed almost $10K that the insurance didn't cover. When she called to dispute it they told her it was her own fault for "going outside our network" as if she had a choice in the matter. :surprise:

In contrast, I've had 3 major surgeries and another week long hospital stay in the last 3 years all at different hospitals, none of which was where I work. My insurance, through my husband's company, covered everything, soup to nuts. I didn't pay a dime for any of it. That's why I made sure he would continue to cover me and being a decent guy he wanted to do it too.
I would fight that. I did fight it with Anthem when a hospital called in a neurosurgeon for my husband. He was out of network and they didn't want to pay. They paid. Did they pay for the ambulance? Are you unionized?
 

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I would fight that. I did fight it with Anthem when a hospital called in a neurosurgeon for my husband. He was out of network and they didn't want to pay. They paid. Did they pay for the ambulance? Are you unionized?
We are not unionized. I told her to fight it. She is not the type of woman to ever do more than one phone call about it, get turned down, and then pay the bill and ***** about it for years. I have countless stories of her allowing herself to get screwed over but I don't want to thread jack. They paid a small amount towards the ambulance. As I said, healthcare is notorious for providing horrible insurance to their employees. I feel bad for all my coworkers who have no choice but to get our insurance.
 

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While having many people without health insurance is a problem in the US, the bigger problem is the high cost of health care. The US federal government spends more money per person on health care than do many developed countries with universal health care. We need to focus on making our health care system more efficient and less expensive. That will lower the cost of insurance making it easier for people to afford and making it less expensive to cover those that cannot afford it.
 

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As the others have said, it isn't just an issue for those without insurance. The cost of insurance is crazy, the tying of it to your job is also a burden. People cannot change jobs, cannot start businesses, etc, without risking long term financial ruin.

Also, as much as people in the US like to point to how some socialized countries have to wait for something: https://thehill.com/blogs/pundits-blog/healthcare/346652-too-many-americans-with-insurance-are-being-denied-coverage

People in the US also have to wait, get denied coverage for things, or cannot afford their share of the costs even with insurance.

I pay more for insurance than I do FICA.
 

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Re: How big of an issue is health insurance in the next election?

I heard today that somewhere near 30 million people in the US don't have health insurance. A quick and dirty calculation show ~ 90% of people have some form of health insurance. Is 10% of the population without health insurance enough to get people excited about moving to "medicare for all" or some other nationalized system. Maybe these numbers are wrong.
When I went to engineering school a long time ago, anything with a 7 as the power-of-ten exponent was still considered a pretty big number.

For comparison, that population is larger than that of NY City, Los Angeles, Chicago, Houston, Phoenix, Philadelphia, San Antonio, Dallas, San Diego, and San Jose combined - the nations most populous cities.

Is is one of the greatest moral failings of a our country.
 

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Putting aside "insurance", I think its very important that healthcare be available or everyone.

I don't want people with communicable diseases - lots of infected people provide more chances for diseases to mutate into more dangerous forms, and increase the chances of infecting others.

I don't want people dying on the streets. I don't want sick children. Some might call my feelings irrational, but these are things I do not want to happen.

I think in many cases illness can cause people to be less productive, be of less benefit to society.


How to best achieve those goals is a different question. I don't think medicare for all is the best approach, even though I agree with the goal.
 

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Some would consider having 90% of the populace insured to be quite an accomplishment given Americans' fierce need for independence and loathing of being told what to do by anyone.

Also, we're still getting acclimated to the welfare reforms where a subset of women who thought it was the government's job (their neighbor's job) to support them can't sit on welfare for the majority of their lives while cranking out babies to continue the gravy train. It takes a while to adjust expectations.
 

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Your numbers aren't far off of what I found, and 90% coverage sounds pretty good.

But not all insurance is equal. There are a shocking # of bankruptcies caused by medical expenses, according to what I can find, about 350,000 families. Of course if someone who owes you money declares bankruptcy, that isn't good for you.

We are seeing health care deserts in the USA, where you have very few providers, partly b/c many of their clients can't pay. If you live there, you have poorer choices whether you have insurance or not.
 

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Discussion Starter #16
I'd like to see bankruptcy law set up with a special category to allow people to file and seek relief only for medical expenses with exemptions for their other debts. (mortgage, cars, et cetera) while credit scores would not reflect bankruptcy for "medical expenses only"
 

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I'd like to see bankruptcy law set up with a special category to allow people to file and seek relief only for medical expenses with exemptions for their other debts. (mortgage, cars, et cetera) while credit scores would not reflect bankruptcy for "medical expenses only"
I've read that the problem with the data about medical costs causing bankruptcies is that it's very easy to distort statistics.

Basically, if a person who files bankruptcy has any medical bills, they count it as a bankruptcy caused by medical bills.


"
During the push to pass the Affordable Care Act, President Barack Obama often described the “crushing cost of health care” that was causing millions of Americans to “live every day just one accident or illness away from bankruptcy” and repeatedly stated that the high cost of health care “causes a bankruptcy in America every 30 seconds.” Stories of illnesses and injuries with financial consequences so severe that they caused households to file for bankruptcy were used as a major argument in support of the 2010 Affordable Care Act. And in 2014, Senators Elizabeth Warren (D-MA) and Sheldon Whitehouse (D-RI) cited medical bills as “the leading cause of personal bankruptcy” when introducing the Medical Bankruptcy Fairness Act, which would have made the bankruptcy process more forgiving for “medically distressed debtors.” But it turns out that the existing evidence for “medical bankruptcies” suffers from a basic statistical fallacy; when we eliminated this problem, we found compelling evidence of the existence of medical bankruptcies but discovered that medical expenses cause many fewer bankruptcies than has been claimed.

Policymakers’ beliefs about the frequency of medical bankruptcies are based primarily on two high-profile articles that claim that medical events cause approximately 60% of all bankruptcies in the United States.1,2 In these studies, people who had gone bankrupt were asked whether they’d experienced health-related financial stress such as substantial medical bills or income loss due to illness. People were also asked whether they went bankrupt due to medical bills. People who reported any of these events were described as having experienced a medical bankruptcy. This approach assumes that whenever a person who reports having substantial medical bills experiences a bankruptcy, the bankruptcy was caused by the medical debt. The fact that, according to a 2014 report from the Consumer Financial Protection Bureau, about 20% of Americans have substantial medical debt yet in a given year less than 1% of Americans file for personal bankruptcy suggests that this assumption is problematic. Clearly, many people face medical debt but do not go bankrupt. Even after correcting for overly broad definitions of “medical” expenses,3 the existing, widely cited evidence on medical bankruptcy is built on the fallacy that when two things occur together there is necessarily a causal relationship between them."


Here's the full article about a much more accurate study that shows a that it's not very common for someone to file bankruptcy based on medical bills as the primary reason.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/#R1
 

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Discussion Starter #18
Good to know Ele. Just goes to show me how I can be misled if I simply take everything at face value.
 

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Good to know Ele. Just goes to show me how I can be misled if I simply take everything at face value.
It seems that we are being lied to from all angles these days. People/organizations have agendas and they cherry pick the data they use to support their agenda.

Your idea of having some kind of special rules for bankruptcy for medical debt would make sense in very carefully defined cases. Otherwise there would be no need for medial/health insurance. Instead just run up the bills and then go to bankruptcy.
 

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Here is something to contemplate.

So Bernie, etc. wants to put the whole country on Medicare... you know Medicare for all. I remember Kamal Harris saying that it will be wonderful because a person will not have to check to see if a procedure is covered, etc. She clearly has no idea how it works.

Medicare does not cover prescription drugs. So a person has to buy what is called a Plan D policy for that. They typically cost between about $23 to $90 a month depending on the level of coverage. Plus typically (unless you get the real expensive plan) have an annual deductible of up to $435 and of course co-pays depending on the type of drug. Then, they have the "donut hole", or coverage gap.

The coverage gap begins after you and your drug plan have spent $4,020 on covered drugs in 2020.

There are special rules in the coverage gap depending on the type of drug.

1. Brand named drugs - you pay 25% of the drug cost and the drug plan pays 75%. All that you and the plan pays counts toward the total out of pocket towards getting out of the coverage gap.

2. Generic drugs - only the 25% that you pay counts toward the total out of pocket towards getting out of the coverage gap.

3. Drugs not covered by the plan (differs by each company/plan - amount spent on them do not apply towards getting out of the coverage gap.

The coverage gab (donut hole) ends once you and your plan have spent $6,350. You then enter the catastrophic coverage. During this period, you pay significantly lower copays or coinsurance for your covered drugs for the remainder of the year.

Now because that is not complicated enough, there is more....

Plan D policies are provided by private insurance companies. They are usually between $23 and about $90 a month depending on deductibles, co-pays, etc. But there is another glitch. The policies don't pay for all drugs. Let me explain.

I spent this evening searching for a Plan D policy for a friend of mine. Since I've been dealing with this Medicare nonsense for the last few years I offered to help him. It's confusing to put it mildly.

He's diabetic, type 2. He uses an insulin called Basaglar Kwikpen. It turns out that the AARP Plan D policies do not cover that drug. So I had to search for a company that does. I found 3 companies. One of them does not offer policies in NM. Aetna does cover the drug. He and I will do more searching tomorrow to try to find other policies to see what his options are.

There is another drug, Xarelto (blood thinner), that AARP covers but Aetna does not.

Xarelto is over $562 a month. Basaglar Kwikpen for him, is about $150 a month. But they both are written in 3 months persecutions. If he cannot find a Plan D that covers both of the, then what?

So a person has to search though all of the many many Plan D polices available, entering the drugs that they take to find one that covers all, or most of the drugs that they take. If, during the year, a person's drugs change or they get a new prescription, they could basically be screwed. My understanding is that noncovered

The above is the high level description of the wonders of Plan D. There are more complications but it would take a book to explain it all.

This is apparently the prescript drug plan that Bernie and company want you all to have. Could you imagine what it would be like to have to have a drug plan for a family and figuring out what plan covers any drugs that family members are taking?

Anyone on Medicare needs to double check their policy each year to make sure that it still covers their prescriptions (if they are on any).

https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-costs/the-part-d-donut-hole

And then, there are the Medicare Supplemental plans and Advantage plans to help pay the things that Medicare itself does not pay for. So SS withholds money from SS income for the Medicare premium. Then there is the Plan B premium. And then a premium for either a supplemental policy or an advantage policy.. these are private insurance policies to cover much of what Medicare does not over.

It's all way too cumbersome. Not a good solution at all.
 
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