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re: What’s the point of medical insurance?

Posted on 6/22/22 at 12:28 pm to
Posted by LSUtoBOOT
Member since Aug 2012
20411 posts
Posted on 6/22/22 at 12:28 pm to
There are doctors (providers) and patients (customers), insurance is a very highly compensated middleman that does little for either party in the transaction. As long doctors and hospitals continue to offer highly inflated prices at the behest of the very powerful insurance industry, average Joe’s will have to continue to kiss the ring of big daddy insurance man.
Posted by bird35
Georgia
Member since Sep 2012
13624 posts
Posted on 6/22/22 at 12:32 pm to
I’m the perfect example of why we need medical insurance.

Started working at the age of 24 and bought medical insurance. Never put much on it over the years except the birth of my three kids

Then at age 46 I was diagnosed with cancer which required three surgeries and four radiation treatments over a four year span. The cost of these treatments were over 300,000$. Due to my medical insurance I paid 4,000$ each year for those four years.

Now I’m good and back to hardly using it.

But I’m sure glad I had it when I needed it.

Posted by Hopeful Doc
Member since Sep 2010
15388 posts
Posted on 6/22/22 at 12:33 pm to
quote:

I'm a big fan of HSA's


Me too.

Isn’t it silly that the maximum contribution to an HSA is less than the maximum out of pocket expense for an individual or family?
Posted by cheobode
Member since Dec 2017
1545 posts
Posted on 6/22/22 at 12:42 pm to
I get having insurance and I pay a pretty penny for my family coverage. However, it seems like I have to do their job for them. Constantly getting bills where I've already paid my co-pay when I go to the same walk in I've been going to for the past 10 years.
Posted by Hopeful Doc
Member since Sep 2010
15388 posts
Posted on 6/22/22 at 12:43 pm to
quote:

Why am I paying every paycheck for medical insurance only to have to pay again if I need to see a doctor?


Don’t confuse “healthcare” and “insurance.”
You’re paying for insurance. Insurance is generally defined as a small monetary risk you take so you don’t get hit with a “jackpot” type of bill. The details are available when you sign up for it. Some have higher premiums and no copays. Some have lower premiums and higher out of pocket costs. It is not designed to be a way to pay for healthcare (excluding some rare exceptions). It is designed to avoid an unpayable circumstance.


quote:

Then on top of that nobody can tell me a price up front.


The bill, the price, the cost, and the reimbursement are all unrelated numbers due to legislation.
Posted by StatMaster
Baton Rouge
Member since Oct 2005
4513 posts
Posted on 6/22/22 at 12:43 pm to
Catastrophic medical insurance should be covered federally by the gov’t in my opinion. All other procedures and MD visits should be out of pocket.
Posted by AUCE05
Member since Dec 2009
45369 posts
Posted on 6/22/22 at 12:46 pm to
I am a big advocate for the single payer system. Open competition. But you are labeled a Marxist if you say our current system is a joke.
Posted by Hopeful Doc
Member since Sep 2010
15388 posts
Posted on 6/22/22 at 12:50 pm to
quote:

I am a big advocate for the single payer system. Open competition.



I’m sorry. Can you please explain how “single payer” and “open competition” are not contradictory terms?
Posted by TDsngumbo
Member since Oct 2011
50770 posts
Posted on 6/22/22 at 12:52 pm to
quote:

Why am I paying every paycheck for medical insurance only to have to pay again if I need to see a doctor?

You have to pay a portion of the claim every time you make an insurance claim? The horror!!!
Posted by Clames
Member since Oct 2010
19570 posts
Posted on 6/22/22 at 12:54 pm to
quote:

Why am I paying every paycheck for medical insurance only to have to pay again if I need to see a doctor? I’m not one of these free medical insurance for all types, but I’m the sucker that’s paying for all these other people to walk into the emergency room and pay nothing.


I'd be $600,000+ in debt if I didn't have good medical insurance with my two heart surgeries in the last 11 months. So the the relative pittance I've paid in insurance coverage and some fees not fully covered has been a pretty good deal.
Posted by Tridentds
Sugar Land
Member since Aug 2011
23952 posts
Posted on 6/22/22 at 12:54 pm to
The older you get the more it makes sense. Just how it is.
Posted by Clames
Member since Oct 2010
19570 posts
Posted on 6/22/22 at 12:55 pm to
quote:

But you are labeled a Marxist if you say our current system is a joke.



You are labeled an idiot for not having a clue about anything you just stated.
Posted by RT1941
Member since May 2007
32075 posts
Posted on 6/22/22 at 12:55 pm to
quote:

Then you have to pay a penalty in your taxes

Thanks, Obama
DONALD TRUMP
Posted by TxWadingFool
Middle Coast
Member since Sep 2014
5644 posts
Posted on 6/22/22 at 12:55 pm to
I am a big advocate for the single payer system. Open competition.


Posted by OweO
Plaquemine, La
Member since Sep 2009
122173 posts
Posted on 6/22/22 at 1:08 pm to
quote:

Then on top of that nobody can tell me a price up front.



I am not sure how there isn't more regulations on this. And the only reason I think there needs to be some type of regulations is because when you have some type of emergency, you are going to the closest hospital to get to. You can't shop for prices to see what hospital has the most reasonable prices. You find out after the fact.

Someone might have seen this, it was awhile back, but I want to say it was in Waco, Tx where an investigative reporter went to 3 different hospitals. I want to say two of them were only several blocks from each other, but they found out that for the same procedure, each hospital charged completely different prices. The cheapest was something like $2300.. The highest was $26k. I don't know if that is the exact numbers but there was a huge difference.

Then they showed how prices can vary from person to person. I'll try to look for the report on youtube, the there was something they used to determine the price and there were several factors (none that really had a huge impact on the price other than the hospital saying so) that played into how much they charge.
Posted by lostinbr
Baton Rouge, LA
Member since Oct 2017
12849 posts
Posted on 6/22/22 at 1:20 pm to
quote:

Isn’t it silly that the maximum contribution to an HSA is less than the maximum out of pocket expense for an individual or family?

Isn’t out of pocket maximum set by your specific insurance policy? Or is that regulated by the government (I genuinely don’t know.)

The max HSA contribution is just about taxes and limiting deductions/tax havens. Not saying it’s right, but that’s just the reality.

I am a big fan of the HDHP’s that come with HSA’s. Seems to me like they help to solve a lot of the problems with the healthcare business model. Particularly for prescription drugs - I have a HDHP and I pay much closer attention to my prescriptions, and will call the doctor and ask for alternatives if it’s too ridiculously priced (depending on the need, obviously). Other times I won’t fill a prescription unnecessarily if, for example, it’s a drug that I already have at home.

The more people adopt these types of policies, the more it pushes the industry toward actual competition.

ETA: Typo.
This post was edited on 6/22/22 at 4:53 pm
Posted by TBoy
Kalamazoo
Member since Dec 2007
28582 posts
Posted on 6/22/22 at 1:23 pm to
quote:

Medical insurance has got to be one of the biggest crocks of shite out there.

I agree. Our choices are pay for medical insurance or nationalize health care delivery and institute a national health like other countries have done.

What is your choice?
Posted by Nutriaitch
Montegut
Member since Apr 2008
10923 posts
Posted on 6/22/22 at 1:28 pm to
quote:

Why am I paying every paycheck for medical insurance only to have to pay again if I need to see a doctor?


just in case within a 3 year stretch you:
have a heart attack required an emergency angioplasty
a month later have another angioplasty for smaller blockages discovered during the first (but not performed until after first procedure healed)
have double bypass surgery because the stents failed 2 years later.
and have reconstructive shoulder surgery



Posted by Spaniard
Pine Belt
Member since Apr 2011
1198 posts
Posted on 6/22/22 at 1:30 pm to
Look at how many people in the office that make an exorbitant salary you have to pass through before you even lay eyes on the doctor.
Posted by StatMaster
Baton Rouge
Member since Oct 2005
4513 posts
Posted on 6/22/22 at 1:30 pm to
quote:

What is your choice?


Catastrophic covered by Nationalized health insurance. All other visits pay out of pocket.
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