Yakoob on 3/7/2012 at 23:36

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And I already said that in my post:



Everyone talks about ObamaCare and how it's universal socalist healthcare, so either they throw " OMG COMMUNISM" shitbricks or talk about how it will make US the healthutipia where the poor and the weak will not need to worry about their health bills. It does neither.



My point is that it illustrates the Government's intention: higher cost to individuals, particularily, as Sg3 points, the poor variety, and bigger profits for insurance companies. After all, ObamaCare is only the beginning, so it's not unwise to think of its long-term intention.

Accessibility is definitely one, and a good one I fully support. But so far it has done little to suggest it means to actually make it affordable.



Yes, but your premium is higher, and you dont get free health doctor visits until you meet your deductible, hence my point - it is worse for day-to-day healthcare, and only better in emergency situations.

and the 10k figure is roughly deductible + out of pocket, basically how much of your own cash you need to put in before you stop paying and your healthcare plan actually provides "universal free socialist healthcare" or whatever buzzwords people want to use.

heywood on 5/7/2012 at 08:31

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Yakoob -

Don't go uninsured. All it takes is one fall off your bike that requires an ambulance trip and ER admission and you're out $3k easily. And if you require surgery or get cancer or something you'll have a mountain of debt and collectors chasing you forever. It's an unbelievable risk you're taking.

You said the non-HSA plan has a monthly premium of $100, which is $1200 a year. Suppose you see your primary care physician for a routine annual checkup ($35 annual copay). And you're on some medication for which there is a generic ($15/month copay). And suppose something comes up in the year and you have to make a one-off visit, followed by a trip to see a specialist ($35 and $50 copays) and a one time prescription for something else ($35). That's a typical year for a healthy person, and if I total that up it comes to $1535. That's not terrible, in fact it's cheaper than I expected.

Now if something bad happens and you need emergency care or hospitalization, then you're responsible for $3500-7500. That's a bit steep, but you can probably opt for a higher monthly premium to lower the annual deductible and out of pocket maximum. But assuming you're a young healthy person, I wouldn't. Do not go for a HSA. HSAs are for people who have significant predictable health care costs every year, not for people who only require health care sporadically.

Yakoob on 5/7/2012 at 17:34

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Fafhrd thanks for your input and links, I will check it out. As much as I enjoy sperging about healthcare, I wouldn't mind being proved absolutely wrong because, hey, this means I can actually get healthcare!





So to address your point - ok I concede my HSA hate is a bit misguided, then; I always heard about it in relation to ObamaCare and naturally assumed it was part of it but I was wrong. Funny how between all the resaerch on it (including reading the lengthy IRS website) I did it never occured to actually check the date :p



Hmm I need to resaerch it more. Basically I looked at variety of insurance companies (Kasier, Aetna, Blue Shield, Sigma etc.) and even met with like two insurance-specialists (or whatever their name is) that were NOT representatives of any particular companies and the plans they suggested were not much better than what I found. No one mentioned subsidies or "other options" tho.



But see that's my point, if I do fall off my bike and need a trip to ER, from my understanding, I would STILL be paying the $3k myself since the decutible alone is like $6k, and most advanced procedures and hospital visits usually are not covered until it is fully met :/

Diseases like cancer I am not so worried about, as that is exactly why I do annual physical, bloodwork etc. The one I did few months ago basically showed I am in amazing health on every indicator possible. I also don't take any medicine or supplements.

And you are acting as if I don't have any savings or a safety net. I do, exactly for these kind of emergencies; I'd rather put the 100 bucks a month into a savings account than give to a company that will STILL make me pay out of my own pocket for procedures. I've been doing it for a while now.

Basically, I am taking my healthcare in my own hands instead of letting an insurance company manage it for me at steep cost and unbeneficial policies. I do realize most of the people don't do that, however, and neither bother with checkups+preventive care, nor have much of emergency savings, hence when "shit goes down" the government needs to foot the bill. But I am not one of them, and it's just aggravating that those who are smart and plan ahead (notice I am NOT saying rich) are effectively penalized because of those who are not (notice I am NOT saying poor). Why can't we have options that cater to both? HSA is such a missed opportunity for a government-subsidized self-managed healthcare...

And yes I know I can never be 100% prepared and there is always a risk of a bigger thing coming in and swooping me I am unprepared for, but as I said, it is a "gamble" I am consciously willing to take given my *current* situation, health and savings etc. Of course, each year as I get older, I re-evaluate my options and there will definitely be an age, maybe 5, maybe 10 years from now, when my risk factor or income will naturally increase to a point where I will get full-on emergency insurance as a viable option.

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As an anecdote, I recently chipped my tooth, which set me back $250 and needs a $700 crown. I started looking at dental insurance and, I still need to check a few sources, but so far it looks like it confirms my reason for not having insurance:
* 6-month wait period
* only covers 50% of the procedure
* only covers the shittiest metal crown, not even with ceramic coating
* usually has upper limit of how much it will pay, like measly $500 in one case.

Taking all those into account, I would end up shelling out about the same on insurance + the 50% cost for the crappiest crown available, than if I paid in cash with no insurance for a higher-grade crown.

I understand that "business is business" and if I got the same quality at the same price as my own cash it means the insurance company would be making 0% profit and could not be afloat, hence they must be more pricy or lower quality.

But then we are talking of insurance as a commercial business in which case, I do NOT agree I should be forced into it.

Muzman on 6/7/2012 at 04:27

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I don't think anyone who has actually seen universal socialist health care would call it such.

Anyway, as I said, it is possible, so far as I understand it, that healthy individual insurance buyers are getting the short end of the stick in this. But that's mainly because of where most of the insurance actually is (ie, employer based plans) v. the uninsured problem.

(http://www.nytimes.com/2012/07/01/business/health-care-ruling-lets-the-system-evolve-economic-view.html?_r=2&smid=tw-share&pagewanted=all) This NY Times article covers what seem to be most of the ideals for the bill that I've absorbed. There is a pact with the devil-ish quality about it the way the insurers' position is maintained, but while it might seem like the government is forcing you to pay for nothing the new inability to refuse cover, for starters, is a pretty big deal in the scheme of things. That is a massively un-economic hit for insurers in the long run.
It's not the the creation of a perfect solution. It's the only way to start to break the US insurance cost death spiral that would actually get through (The dems themselves would have voted against single payer).

heywood on 11/7/2012 at 09:13

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Sorry, I missed seeing your question. Muzman or Shug (or the other Aussies here) would be better to ask about it since I've only been living here a little over 2 years. Anyway, Australia has a mixed public/private system. The public component is called Medicare and consists of public hospitals and a reimbursement system which covers all permanent residents. Most people seem to get their routine health care needs met by private medical practices, and Medicare generally covers the vast majority of the expense (with some limits and small out of pocket costs). Same for pharmaceuticals. The public hospitals are free for Medicare recipients, but there are also private hospitals. Australia has a number of private health insurers, and the government encourages people to get private insurance by offering rebates for premiums and a tax break. Something like 1/3 to 1/2 of Australians have some form of private health insurance and I believe the trend is increasing.

My personal experience with the system is very limited: just a couple of office visits, some tests, and two prescriptions. I have no complaints. My first impression is that the quality of service and competence of practitioners is similar to what I experienced in the US. And the prices charged for office visits, tests, and prescriptions are somewhat less. I do hear some complaints, e.g. long waiting periods for elective procedures, two tiers of service, and some people have to go overseas and spend a fortune to get treatment for rare diseases. But overall a lot less complaining than in the US. It could be a model for the US to follow if a "public option" were put back on the table.