Health insurance (HMSA, Kaiser, etc), Medicare, and Medicaid are some things that I experienced while taking care of my dad.  Luckily, in general, my dad's health costs were covered since he had dual coverage with HMSA and Medicare.  However, it was somewhat of a nightmare at times weeding through the rules, even for hospital admin/accountants.  To the point where they were quibbling over whether or not what condition would constitute admittance being covered even with orders from Doctors.  Changes in care plans isn't something that they seem to deal with.  An example is if someone comes in for something planned as outpatient and then needs to be admitted.  Quite frustrating at times.

Overall, I believe the healthcare industry is effed up.  It is my opinion that admin and others are business minded, not healthcare minded or priortized.  Just more greed people getting rich at patient's expense.  Even for me.  My back surgery was put off while insurance was being figured out.  Whereas maybe 2 years before, my Doc said he could've gotten me into the OR the day after the initial consult.   

There are actually some good things about Medicare that I like. If you paid into it all your working years, then the cost is minimal even tho the coverage is not great. But there are also supplement plans which approximately double the cost but they pay the remainder of what Medicare doesn’t cover. It literally gives you almost 100% coverage of average issues for less than $350/month. Considering my Obamacare plan is almost $900/month (Some of which is supplemented by you working stiffs ) next year for lousy coverage, Medicare with a full supplement plan starts looking like a bargain.

Most every doctor knows how to work the Medicare system. And if they make a mistake, Medicare tells them how or what to do to correct it. They also know what’s covered and what’s not so they don’t waste their time trying to bill for something they won’t get paid for. That’s why medical billing people are worth their weight in gold. Medicare and the supplement plan so far for my wife has paid pretty much 100% of all her medical care. With the exception of one particular blood test and her prescriptions. I like that because paying co payments and deductibles gets involved and complicated as often as my wife needs care. I am still dealing with that particular blood test. I paid it and my check cleared but the test facility never credited my account with my payment. This is the second time. So this time I am just going to wait until they try and collect it. Being proactive did not seem to help after the first time.

This is meant to be reminder to those Vets here.
Get enrolled in the VA medical system. My drug costs are $8 per prescription
per month regardless of what the drug is.
I just received my Medicare card and that card costs me more every billing than all
my VA costs (doctors and pills) for all of 2020.

There are actually some good things about Medicare that I like. If you paid into it all your working years, then the cost is minimal even tho the coverage is not great. But there are also supplement plans which approximately double the cost but they pay the remainder of what Medicare doesn’t cover. It literally gives you almost 100% coverage of average issues for less than $350/month. Considering my Obamacare plan is almost $900/month (Some of which is supplemented by you working stiffs ) next year for lousy coverage, Medicare with a full supplement plan starts looking like a bargain.

Most every doctor knows how to work the Medicare system. And if they make a mistake, Medicare tells them how or what to do to correct it. They also know what’s covered and what’s not so they don’t waste their time trying to bill for something they won’t get paid for. That’s why medical billing people are worth their weight in gold. Medicare and the supplement plan so far for my wife has paid pretty much 100% of all her medical care. With the exception of one particular blood test and her prescriptions. I like that because paying co payments and deductibles gets involved and complicated as often as my wife needs care. I am still dealing with that particular blood test. I paid it and my check cleared but the test facility never credited my account with my payment. This is the second time. So this time I am just going to wait until they try and collect it. Being proactive did not seem to help after the first time.

That was one of things I noted.  In one of the examples of difficulties noted above, I clearly remember the "main" billing person was on leave and the "second best" was on a lunch break.  Just so happens was when we were trying to find out if we were going or staying.

My wife gets Medicare before age 65 because she is now disabled. It is a very onerous path to take and we hired a lawyer to help us through the process because we couldn’t afford the more common process of trying to do it ourselves. When you try to get it yourself you are prone to having to get turned down usually twice and then hire the lawyer to represent you at the final appeal. There is around an 80% failure rate. So we hired the lawyer in the beginning of the process and they filled out the paperwork and did some legwork for us making sure she was approved the first time. Which is rare. Then she had to wait two years to qualify for Medicare. By hiring the lawyer first thing we save at least a year if not two.

Here is the thing about getting Medicare without working and paying into it. For Medicare Part A, once you qualify for Medicare, and have never paid into it, the monthly cost for Medicare part A is quite high IMO. It has no monthly cost if you paid into Medicare as a worker for 40 quarters or more. And Medicare Part B is also quite high in monthly cost if you never worked and paid into Medicare. And basic Medicare coverage is quite bad. To me Medicare is not worth the money at this point. What you get for paying into it during your working years is a huge discount off the monthly premiums. I don’t consider it a tax as it is part of the entire Social Security umbrella that provides help to you when you retire. That is why you get such huge monthly discounts off the monthly premiums if you worked and paid into it. Good, bad or indifferent, the SS program which includes Medicare was designed as a supplement to retirement. Unfortunately, this has become more of a crutch for people who use the SS program as their entire retirement. The thing about Medicare being a tax is that you need not have to pay into it (See below).

The advent of the entire SS System including Medicare being available to those who qualify for SS Disability (whether they ever paid into the system or not) is a much more recent abomination of the system. It was never designed to cover anyone under those circumstances. How it got this way was from politicians making promises to modify the system in exchange for donations and votes. You can imagine the insurance industry was lobbying heavily for that. SS and Medicare were originally designed so that more money went into the system than went out. And it was supposed to have been kept separate from the general fund so politicians couldn’t get their hands on it. Of course that changed as well. Which is why the entire system is now going bankrupt. But that again is another topic for discussion. Originally only people who paid in received the benefits of the system. When you start including people who never pay into the system then more money goes out than comes in. But there are still other reasons I don’t consider it a tax. And that is due to the fact you can work all your life for a state or local government and as long as you are covered by a qualified health plan like my friends who paid into CalPers then they never had SS nor Medicare taken out of their checks. Not a tax.

Now Obamacare is another story. Obamacare as you noted is healthcare and not health insurance. Mostly defined this way due to the fact that no one is turned down due to a previous condition. But in my opinion it is a tax. Because the Obamacare program requires you to be covered under your employers health plan which you pay for directly or indirectly, or you have to buy into Obamacare. The only other choice you have is to pay a non participation tax. But that is taxation without representation and is illegal under our system. In my opinion this is a tax. And in my opinion forcing a tax upon someone who receives no benefit is socialism.

Sorry this is so long. To sum things up, SS and Medicare were not originally supposed to be government subsidized. The idea was more money coming in than going out. And funds kept separately. And it worked great for a long time. And if the program had never been expanded to include those who never paid into the system and if the funds were not dumped into the general fund where politicians could raid the funds and steal it from retirees then even with the advent of the Boomers retiring I believe the system could have handled it until the Boomers started dying off faster than they are retiring. So eventually the system will go bankrupt and it will have to become government subsidized or radically changed. But at this time it is not subsidized by the government. It is administered by the government but not subsidized. Obamacare is both administered and subsidized by the government. I am on Obamacare not by my choice. And my premiums are partially paid to Blue Cross by the government which is a subsidy. It is very expensive and I have poor coverage. But that is another topic for another time.

Thanks for the history lesson. I guess getting into the weeds, one could favor the old medicare system but not all the new additions. I am young enough where I haven't bothered to look into how to apply for all the benefits. I have heard great stories about medicare and terrible stories about medicare so I don't really have an opinion on it one way or another. As I said I favor some government subsidized health care but not full blown government system. Unfortunately it is such a complicated market with so many moving parts and incentives not to change it for the better. Lots of intriguing ideas on how to go about it though.

Unfortunately one of the worst parts about this type of program is when the government raids it for other things. It is even worse when the republicans do it but that is another issue.

I agree with you on Obamacare, it is and was always a tax. My biggest criticisms is that it really didn't do much to make healthcare affordable, only tried to make insurance more affordable (which in some ways it did and others it failed). Obamacare seemed like trying to compromise between everyone getting coverage while still letting the market work, But the failure there is that the market isn't working well for the consumer right now.

I have a special needs brother who lives in another state. He functions well enough he can usually hold down real basic job like a dishwasher but can't manage his money well. For people like him I do believe there should be a social safety net. But for the average person not everything should be free and provided for either.

Thanks for the history lesson. I guess getting into the weeds, one could favor the old medicare system but not all the new additions. I am young enough where I haven't bothered to look into how to apply for all the benefits. I have heard great stories about medicare and terrible stories about medicare so I don't really have an opinion on it one way or another. As I said I favor some government subsidized health care but not full blown government system. Unfortunately it is such a complicated market with so many moving parts and incentives not to change it for the better. Lots of intriguing ideas on how to go about it though.

Unfortunately one of the worst parts about this type of program is when the government raids it for other things. It is even worse when the republicans do it but that is another issue.

I agree with you on Obamacare, it is and was always a tax. My biggest criticisms is that it really didn't do much to make healthcare affordable, only tried to make insurance more affordable (which in some ways it did and others it failed). Obamacare seemed like trying to compromise between everyone getting coverage while still letting the market work, But the failure there is that the market isn't working well for the consumer right now.

I have a special needs brother who lives in another state. He functions well enough he can usually hold down real basic job like a dishwasher but can't manage his money well. For people like him I do believe there should be a social safety net. But for the average person not everything should be free and provided for either.

It is hard not to speak to the details of the SS, Medicare, Medicaid and Obamacare without getting into the weeds.

So you made the statement that Obamacare tried to make insurance more affordable. Then you said in some ways it did. I am not aware of any way it did. Perhaps you can elaborate on that?

You also said that the market isn’t working well for the consumer right now. As it turns out before Obamacare the market for health insurance only was working well for the consumer. But we were told it was not and that insurance was too expensive. I’m not including drug pricing in my statement. This is verified by the way Obamacare actually took away the market for the consumer by practically eliminating all competition. Which is one reason healthcare premiums increased over 100% in one year here in AZ. Due to the way Obamacare was implemented the insurance companies couldn’t compete and make any money. Especially the smaller companies. So only the largest companies stuck it out until they all left except one. Which of course removed competition and allowed the one remaining company to raise prices at will. Another way Obamacare raised prices is by forcing someone who can’t get coverage thru an employer or thru Medicare (IE Me) to get coverage thru the government. And now that there is only one company providing Obamacare thru the government portal so I have no choices. It is Obamacare thru Blue Cross or I have no coverage and have to pay a tax penalty for not being covered. Because the legislature did not remove the restriction on buying insurance across state lines I cannot shop for insurance. And of course the coverage on said insurance is not good at all. While there are many other reasons, these are the two main reasons that the market is not working well for the consumer right now. If you couldn’t tell I am angry about this.

As far as your brother is concerned I am sorry. What I will say is that my wife used to work for a non profit there in Hawaii, that specialized in helping people like your brother to live on their own. This includes helping them with their finances and shopping and money handling in general. They helped them get jobs, helped with transportation and medical needs. They offered a whole slew of services that of course were paid for by grants and subsidized by the government. Unfortunately this company was shuttered by the Feds when they found the CEO was tapping the grant money for himself. But I’m sure there are other companies there doing the same thing. If he already is not taking advantage of this type of service I highly recommend seeking one out. It will help him live on his own and I am sure you know that makes a huge difference in their quality of life.

It is hard not to speak to the details of the SS, Medicare, Medicaid and Obamacare without getting into the weeds.

So you made the statement that Obamacare tried to make insurance more affordable. Then you said in some ways it did. I am not aware of any way it did. Perhaps you can elaborate on that?

One of the things Obamacare did (if I understand correctly) was to set limits on how high insurance can be set compared to the lowest prices. So for example you couldn't set grandma's insurance 100x that of grandson's insurance. I believe the number was like 6x but I would have to look it up. This made insurance cheaper for grandma but more expensive for grandson. Another way is the subsidies and while that is not technically cheaper insurance, it made insurance more affordable to the lowest income earners. Downside was that it also bumped up premiums for a lot of other middle to high income earners. I don't know the breakdown but part of this I think is from the subsidies but other parts were also regulations, such as prohibiting using preexisting conditions to deny payment for care. I think there are a few other ways but those are two of the main examples I can recall.

You also said that the market isn’t working well for the consumer right now. As it turns out before Obamacare the market for health insurance only was working well for the consumer. But we were told it was not and that insurance was too expensive. I’m not including drug pricing in my statement. This is verified by the way Obamacare actually took away the market for the consumer by practically eliminating all competition. Which is one reason healthcare premiums increased over 100% in one year here in AZ. Due to the way Obamacare was implemented the insurance companies couldn’t compete and make any money. Especially the smaller companies. So only the largest companies stuck it out until they all left except one. Which of course removed competition and allowed the one remaining company to raise prices at will. Another way Obamacare raised prices is by forcing someone who can’t get coverage thru an employer or thru Medicare (IE Me) to get coverage thru the government. And now that there is only one company providing Obamacare thru the government portal so I have no choices. It is Obamacare thru Blue Cross or I have no coverage and have to pay a tax penalty for not being covered. Because the legislature did not remove the restriction on buying insurance across state lines I cannot shop for insurance. And of course the coverage on said insurance is not good at all. While there are many other reasons, these are the two main reasons that the market is not working well for the consumer right now. If you couldn’t tell I am angry about this.

As far as your brother is concerned I am sorry. What I will say is that my wife used to work for a non profit there in Hawaii, that specialized in helping people like your brother to live on their own. This includes helping them with their finances and shopping and money handling in general. They helped them get jobs, helped with transportation and medical needs. They offered a whole slew of services that of course were paid for by grants and subsidized by the government. Unfortunately this company was shuttered by the Feds when they found the CEO was tapping the grant money for himself. But I’m sure there are other companies there doing the same thing. If he already is not taking advantage of this type of service I highly recommend seeking one out. It will help him live on his own and I am sure you know that makes a huge difference in their quality of life.

Hmmm, working well for the consumer could be looked at a number of ways: price, quality, speed, etc. I certainly agree that Obamacare has hurt the consumer in a number of ways though. However if we go back to the ban on using pre-existing conditions to deny coverage, this becomes a double edged sword for the consumer. It raises the cost for insurance but also prevents the insurance from using that sort of technicality to deny coverage. Is that a win? Depends on whether you could have been denied a pre-existing coverage I suppose. As for shopping across state lines, I sure don't think it would hurt costs however I have read a number of sources which suggest the savings to the consumer would not be significant. Plus, isn't competition non-existent already for a lot of people? Those people who only have Kaiser as an employer choice can't shop around, furthermore, who reads all the fine print on their health insurance before they sign up anyway? It is messy and I have heard countless anecdotes about horror stories with exorbitant prices and the tiniest of loopholes leaving even families with insurance in massive debt.

As for my brother I am not really involved in his life much. My dad set up a system so that money will slowly but regularly be put into his account even after my dad dies. This will help him function day to day but not with the big things. He probably has a social worker too, I just don't know the details on that end.

One of the things Obamacare did (if I understand correctly) was to set limits on how high insurance can be set compared to the lowest prices. So for example you couldn't set grandma's insurance 100x that of grandson's insurance. I believe the number was like 6x but I would have to look it up. This made insurance cheaper for grandma but more expensive for grandson. Another way is the subsidies and while that is not technically cheaper insurance, it made insurance more affordable to the lowest income earners. Downside was that it also bumped up premiums for a lot of other middle to high income earners. I don't know the breakdown but part of this I think is from the subsidies but other parts were also regulations, such as prohibiting using preexisting conditions to deny payment for care. I think there are a few other ways but those are two of the main examples I can recall.



Hmmm, working well for the consumer could be looked at a number of ways: price, quality, speed, etc. I certainly agree that Obamacare has hurt the consumer in a number of ways though. However if we go back to the ban on using pre-existing conditions to deny coverage, this becomes a double edged sword for the consumer. It raises the cost for insurance but also prevents the insurance from using that sort of technicality to deny coverage. Is that a win? Depends on whether you could have been denied a pre-existing coverage I suppose. As for shopping across state lines, I sure don't think it would hurt costs however I have read a number of sources which suggest the savings to the consumer would not be significant. Plus, isn't competition non-existent already for a lot of people? Those people who only have Kaiser as an employer choice can't shop around, furthermore, who reads all the fine print on their health insurance before they sign up anyway? It is messy and I have heard countless anecdotes about horror stories with exorbitant prices and the tiniest of loopholes leaving even families with insurance in massive debt.

As for my brother I am not really involved in his life much. My dad set up a system so that money will slowly but regularly be put into his account even after my dad dies. This will help him function day to day but not with the big things. He probably has a social worker too, I just don't know the details on that end.

I guess I am not aware of the price per age aspect of Obamacare. It’s not important enough for me to go look it up. It won’t change anything for me. What I can tell you, and this is my opinion only, between the terrible coverage and high premium prices it sure feels like the insurance companies had their hand in the writing of Obamacare. The coverages are so bad, the out of pocket above and beyond the monthly premiums is very high and the monthly premiums are very high as well. I wish Kaiser was out here I would go with them if I was “allowed” to. My friends there in Hawaii are paying under $300 per month for Kaiser. That is what they tell me so I cannot verify that. I had Kaiser for a few years while working for one company there. They were actually pretty good. And they did well for my wife, too.

I can hardly wait til I’m 65 and qualify for Medicare as between the monthly premium for Medicare and the Supplement Plan F or G I will only pay out approximately $300-$350 per month and all my healthcare will be covered almost 100%. Not including drugs, dental and vision. I paid into it and I deserve to get the benefits of paying into it.

I’m not so sure we will go back to the pre-existing condition issue. I think enough people feel strongly about it that it will go by the wayside. And we will have healthcare instead of health insurance. But of course that means costs are going to go up. I’m in that category now. And insurance premiums are at an all time high right now. Sad.

I guess I am not aware of the price per age aspect of Obamacare. It’s not important enough for me to go look it up. It won’t change anything for me. What I can tell you, and this is my opinion only, between the terrible coverage and high premium prices it sure feels like the insurance companies had their hand in the writing of Obamacare. The coverages are so bad, the out of pocket above and beyond the monthly premiums is very high and the monthly premiums are very high as well. I wish Kaiser was out here I would go with them if I was “allowed” to. My friends there in Hawaii are paying under $300 per month for Kaiser. That is what they tell me so I cannot verify that. I had Kaiser for a few years while working for one company there. They were actually pretty good. And they did well for my wife, too.

I can hardly wait til I’m 65 and qualify for Medicare as between the monthly premium for Medicare and the Supplement Plan F or G I will only pay out approximately $300-$350 per month and all my healthcare will be covered almost 100%. Not including drugs, dental and vision. I paid into it and I deserve to get the benefits of paying into it.

I’m not so sure we will go back to the pre-existing condition issue. I think enough people feel strongly about it that it will go by the wayside. And we will have healthcare instead of health insurance. But of course that means costs are going to go up. I’m in that category now. And insurance premiums are at an all time high right now. Sad.

What I wonder is how much money can be saved by removing the huge profit motive for insurance companies and certain medical/pharma companies. I am sure billions of dollars. Of course from that savings we would have to deduct government waste and losses in terms of quality and progress in medical treatments. I think we need a balance of private and public health care, neither single one seems to be doing us all that great.

biden gonna reverse all of trump's actions
IF he wins...

Beijing Biden Ends President Trump’s Policy of Reducing Medical Costs on Insulin and EpiPens to Please Big Pharma

https://www.thegatewaypundit.com/2021/01/beijing-biden-ends-president-trumps-policy-reducing-medical-costs-insulin-epipens-please-corporatists/

Beijing Biden Ends President Trump’s Policy of Reducing Medical Costs on Insulin and EpiPens to Please Big Pharma

https://www.thegatewaypundit.com/2021/01/beijing-biden-ends-president-trumps-policy-reducing-medical-costs-insulin-epipens-please-corporatists/

So Big Pharma goes back to ripping off the American Public? Thanks President Biden! Us retirees on fixed income really appreciated being screwed.

So Big Pharma goes back to ripping off the American Public? Thanks President Biden! Us retirees on fixed income really appreciated being screwed.

IIRC, Obungacare was written by big pharma and insurance companies, no way would they shaft themselves out of easy money.

Trump threw a wrench in the gearbox, but they bought the election to get it free.

IIRC, Obungacare was written by big pharma and insurance companies, no way would they shaft themselves out of easy money.

Trump threw a wrench in the gearbox, but they bought the election to get it free.

It is obvious that the insurance companies had their hands in writing Obamacare. The insurance is some of the worst I have ever had. High copays and out of pocket. Low coverage rates and high premiums. And the premiums are subsidized by the taxpayer if you are lower income. Before Obamacare I used to have terrific insurance that covered everything at 90% or 100% with low copays and out of pocket and premiums I could afford. Not only did Obama and the Democrats lie about everyone having insurance but they lied about it being affordable and having good coverage. What they did is pander to the insurance companies and Big Pharma and Special Interest Groups and diverted the cost of this debacle onto the back of the taxpayers.

biden gonna reverse all of trump's actions
IF he wins...

you're a real Dr in my book you should be called OmniDr

https://www.foxnews.com/politics/biden-trump-hhs-rule-lower-insulin-prices