Election Results

[ihartgonzo]

I guess scumbag is harsh. But I get a grimey feeling whenever I watch him. It's unfortunate that the republican party didn't have a better candidate, not that I'm republican, but that's definitely not the candidate out there.

[Romy]

Originally Posted by ihartgonzo

I guess scumbag is harsh. But I get a grimey feeling whenever I watch him. It's unfortunate that the republican party didn't have a better candidate, not that I'm republican, but that's definitely not the candidate out there.

I think Ryan killed it for him anyway. He is way too extreme for the undecided moderates, I know of many many moderate voters, especially women, who don't agree with Obama but were terrified of the prospect of Ryan potentially becoming pres if something happened to Romney.

Looking at how close it was in the end, I really think that if they'd paired him with an intelligent moderate woman (like NOT Bachman, lol) he totally would have won.

[GipsyQueen]

Originally Posted by ihartgonzo

I would love to move to Denmark... my ancestor's homeland. They have socialized medicine & education, amazing people, music programs, animal welfare, AND it's the happiest place on earth! I only wish the US could adapt the same social structure. But I feel like we're too far gone.

Scandanavien Health care systems are pretty amazing. Unfortunatly, places like Sweden, Norway, Denmark and Finland have pretty high day-to-day living costs. Their paychecks are higher though. A friend of mine is in Norway at the moment - when she told me what minium wage was I went: . Your average income is about 4500€ a month. (after taxes).


Germany's health care system isn't perfect - but if I think how little we actually pay when we see a doctor, I'm pretty thankful. You used to have to pay 10€ every quater you visit the doctors... Once 2013 comes along, it's "free" (most of the time)


I was pretty relieved when I saw the election results. But - whats wrong with Florida? Why are they taking so long?

[Renee750il]

Originally Posted by release the hounds

Healthcare providers raise their prices because they have a large pool of cash from which to draw from. Insurance companies raise their prices because people will pay a **** load of money for the illusion of "health" and they have to keep the ceo's and investors happy. It's never ending cycle. They have nice scapegoats like those that don't pay and my favorite, malpractice, but most of that is easy fodder because the masses eat it up.

Healthcare costs so much mostly because insurance is available in the first place.

Part of this is because the insurance industry gets HUGE discounts to what an uninsured person is charged. As an example, my mom had some minor surgery. The cost to the insurance company (less her $200 deductible) was just under $1000.

However, if she had NOT had insurance, had been paying it out of pocket, the charge would have been $10,000.

[Fran27]

Originally Posted by Pops2

we are NOT getting fully social healthcare like canada. the only thing that will change is that your premiums will go up because the insurance companies can't refuse pre-existing conditions. you'll still make up shortfall from the homeless & such (although they might be in prison since they surely won't be buying insurance) w/ your taxes. you'll still be buying health insurance. i have tricare so it won't change anything for me. my primary objection is the individual mandate & the adverse effect it will have on a lot of families barely making. think about this, they can't afford to buy insurance now. they won't be able to afford it after the law takes effect, AND they're going to be fined $2500 by the IRS for not buying it. how precisely is this a benefit to them or anyone?

Well, how many of those people are broke because of medical expenses? How will those people who can't afford $200 a month for a basic plan (totally putting a random number there) be able to afford a $30,000 bill if something happens and they have to go to the hospital? Honestly it's just crazy to me that people don't want health insurance. The meds I need to use alone cost like $1000 a month without insurance. Without them, I'd probably have to go to the hospital a lot. Paying for insurance is just cheaper in the long run.

So... I see both points. But IMO it's still the lesser of two evils.

But something needs to be done about health insurances. In France I was paying $50 out of pocket every month for my meds. Office visits were $15, and I was getting most of that back. I came here, no insurance, and paid $2500 for the same things. It's totally ridiculous. As far as I'm concerned, any business trying to make money out of people's health issues is just absolutely disgusting.

[Pops2]

Originally Posted by ihartgonzo

I guess scumbag is harsh. But I get a grimey feeling whenever I watch him. It's unfortunate that the republican party didn't have a better candidate, not that I'm republican, but that's definitely not the candidate out there.

that's just it there WERE MUCH BETTER candidates. for all the demo hype romney was VERY moderate closer to a moderate dem than any kind of a repub. THAT pushed away a lot of people to 3rd party candidates that want to eliminate the overspending of BOTH parties.

[Romy]

Originally Posted by Fran27

Well, how many of those people are broke because of medical expenses? How will those people who can't afford $200 a month for a basic plan (totally putting a random number there) be able to afford a $30,000 bill if something happens and they have to go to the hospital? Honestly it's just crazy to me that people don't want health insurance. The meds I need to use alone cost like $1000 a month without insurance. Without them, I'd probably have to go to the hospital a lot. Paying for insurance is just cheaper in the long run.

So... I see both points. But IMO it's still the lesser of two evils.

But something needs to be done about health insurances. In France I was paying $50 out of pocket every month for my meds. Office visits were $15, and I was getting most of that back. I came here, no insurance, and paid $2500 for the same things. It's totally ridiculous. As far as I'm concerned, any business trying to make money out of people's health issues is just absolutely disgusting.

It's cheaper in the long run if you get hurt or sick. But for many families who are getting by paycheck to paycheck, the $$ just isn't there for insurance so it's just not possible. I can't afford it. The $$ is just absent. Been job hunting for months, still nothing. Thousands upon thousands of people are in the same situation.

My mom has to buy insurance because she's older and has some age associated medical expenses. She used to pay $200 a month for private insurance. Since Obama introduced Obamacare and the thing where they can't deny preexisting conditions, they jacked up her premium to over $800 a month. And she can't find any private insurance for less than that. That's just for one person, and she still has to pay a $30 copay for visits and a copay for medication. It's super crappy, but she feels like she doesn't have a choice because if she was diagnosed with cancer or something she'd be screwed without it.

If she wasn't a homeowner, there's no way she'd be able to afford it. If she had to pay rent, it'd be a choice between health insurance and rent. Many many people don't have that choice. I mean, they could buy insurance but then they and their children would be living under some bridge in a cardboard box.

[crazedACD]

Originally Posted by ihartgonzo

I guess scumbag is harsh. But I get a grimey feeling whenever I watch him. It's unfortunate that the republican party didn't have a better candidate, not that I'm republican, but that's definitely not the candidate out there.

+a million. He's a total sleezeball, just doesn't seem like a good person.

[release the hounds]

Insurance really a racket. It is. Let's say we have an E/M code, moderate complexity and for the geographical region a "normal charge can be between 90-150 bucks. Providers under contract with that ins. company are going to be reimbursed anywhere from 35-70 dollars for that code.

Most providers would be more than happy to accept that from a non insured person too, but they can't "charge" you that much because ins company lobbying has made it "illegal" for a provider to have 2 different rate scales. You can get around this by having a TOS or time of service reduction and it has to be offered to everybody. There are certain criteria that must be met, like the appt has to be made so much in advance and you MUST pay at the time of service. If you only pay part, make a payment plan, get billed later etc it doesn't apply and legally you must be charged the full amount with no applicable discount or the provider runs the risk of being charged with insurance fraud.

But if the provider is only charging 70 bucks for that same 99203 E/M code the insurers gather that info and it wouldn't be long till the reimbursement for those Evaluation codes went down to 35 bucks, so the charges are always going to be much higher.

They also like to dictate procedure codes. They will continually deny certain procedure codes and make it very difficult to get paid. So the providers must pay staff to call, write letters and do appeals in order to get a procedure code paid that should be paid in the first place no questions asked. Usually it involves sending claims, getting denied and depending on the provider certain things happen from there. A lot of the larger ones will jsut pass it on to the patient and make them responsible, because ultimately they are. They can't or won't spend the extra overhead to fight insurance claims for hundreds of other people. But some will. They then have to send in requested notes, and they get denied again. Then they have to write a letter for an appeal and those go thru various stages. Some just a simple phone call, after a 30 minute wait, the adjuster will say, yep, you're right, and then pay it.

Some say up, you're right, the claim will be reprocessed and payment should be recieved in 10-15 days. 15 days later it was denied again and the process starts over and they say, oops. our mistake, we'll have to reprocess, fun stuff.

Others will tell you outright that you can appeal and we'll keep denying it, but if you use "X" code we'll pay. So a lot of providers will just do that, easier and less hassle. The problem in doing that is INS. companies are gathering all that info to deny future claims. they gather all the data and say, "see, nobody is using this procedure code anymore so the therapy or procedure must not be effective" and use that gathered info to deny more claims and other insurance companies latch on.

It's really sad game of back and forth and trying to get paid and deny, but I guess necessary becaus so many try to screw the system in the first place.

[darkchild16]

Originally Posted by Fran27

Well, how many of those people are broke because of medical expenses? How will those people who can't afford $200 a month for a basic plan (totally putting a random number there) be able to afford a $30,000 bill if something happens and they have to go to the hospital? Honestly it's just crazy to me that people don't want health insurance. The meds I need to use alone cost like $1000 a month without insurance. Without them, I'd probably have to go to the hospital a lot. Paying for insurance is just cheaper in the long run.

So... I see both points. But IMO it's still the lesser of two evils.

But something needs to be done about health insurances. In France I was paying $50 out of pocket every month for my meds. Office visits were $15, and I was getting most of that back. I came here, no insurance, and paid $2500 for the same things. It's totally ridiculous. As far as I'm concerned, any business trying to make money out of people's health issues is just absolutely disgusting.

Its not as easy as that though. Health insurance out of pocket for my family with Blue Cross and Blue Shield is:
224.40 with a 5 THOUSAND dollar deductible.
for a $1500 deductible it is
585.00

BEFORE we get into medical history. No maternity, no dental, only the 600 dollar one includes vision.

To take my kids to the dr out of pocket is $120 for a check up and shots, $75 for a sick visit, $100 for a checkup no shots.

For us we have a sliding scale dr. Hospitals will make payment plans/have grants.

It literally would NOT pay for us to have health insurance out of pocket.

Jeremy has been with his job 4 YEARS at full time hours and they refused to give him a full time employment status and that was legally ok.

He gets a limited health plan for all of us with Pizza Hut that we are looking into I need to call them but its been insane with Savannah that I haven't had 2 seconds to figure it all out.

Its not so cut and dry as OMG you are crazy for not having insurance. Out of pocket insurance is CRAZY.