This. When they’re not using it, everyone thinks they have great coverage.
I love my health insurance - like Jason I work for Microsoft.
Scuzz
3643
Over the years I have had Blue Cross and Blue Shield. Aside from the cost, which was about 10% of what it is now 15 years ago, I really have no complaints and have had no headaches. The wife and I have had three scheduled surgeries, one emergency surgery and lots of procedures. My daughter even had a procedure I was surprised that they paid for.
I think part of the problem is that every insurance company offers dozens of different plans with different limits and exceptions. Often the costs are not that different within a company for it’s several plans. States can require differences and many limit or dictate who can treat you.
And of course within every company there are idiots who should be shot.
And the vast majority of people still have great coverage even when they use the plan. But a news headline of ‘health plan covers patients needs’ just doesnt have the same play as talking about the small number of people who have problems with their plan.
jason
3645
It’s one of those things that doesn’t just fail. It fails spectacularly.
People don’t say, “Hmm… I went and had major surgery and my insurance covered everything, except for bed pan changing. That’s odd.” Either it works great or you get stories about an insurance company refusing to pay for heart surgery because the patient had a pre-existing ingrown toenail.
I work at a uni, too.
One of the faculty members had a heart attack while in France a couple of summers ago. He was rushed to the cardiac care center and spent 1 week in hospital. The French doctors apologized, as his insurance wasn’t going to pay all the costs, so he braced himself for the worst.
He was out less than $1000 he’d have to pay on his own, for 1 week in hospital, all the treatment, all the meds. Everything. He’d have had to pay more if he had his heart attack in network.
He was thrilled that he’d had his heart attack in France, with its excellent medical system.
Oh, and on top of all that, he discovered that his heart attack was medicine-induced. Apparently the anti-inflammatory drug he’d been prescribed for heel pain is banned in the EU because gasp it has been linked to heart attacks!
Is that the kind of socialism you damn dirty hippies are trying to bring over here? Disgusting.
I’m pleased with the health care I receive through my employer. That’s the problem, though – through my employer. Seventeen years after initial hire if I lose my job (increasingly common, long before senior-level health care kicks in) or want to go out on my own (aren’t we supposed to be encouraging entrepreneurship in the US?) I’m in a bind. My health care costs skyrocket as I’ve picked up the odd pre-existing condition or so in the meantime. The main thing I want is a decent level of care independent of employment and let the employer-added benefit be in the realm of picking up deductibles, providing for more elective procedures, helping with out-of-pocket medicine expenses, etc.
jason
3649
As yet another example that I simply don’t understand health insurance at all… The largest bill, the hospital stay (time in ER, surgery room, recovery room - we were never officially admitted to a room), finally made its way through the insurance. Previous bills had the following format:
Bill -> Aetna Pays -> Patient responsibility
$10,000 -> ineligible -> $10,000
The only one Aetna paid anything on so far was the surgeon
$2100 -> $1400 -> $700
The hospital stay, however, was as follows
$15,000 -> ineligible -> $15,000
Actually, it wasn’t that simple, it was three pages of an itemized list showing each item, it’s cost, that it was ineligible, and the patient responsibility being the full amount. Then, on the last line is says “PPO Discount $12,871, patient responsibility $2,129”.
So, they refused to cover anything, but they reduced the price by over $12k though some sort of negotiated discount? This is why people hate insurance companies. I got paperwork that for three pages told me “fuck off, we aren’t paying anything” and then had the buried lead that my bill had been reduced to 14% of the original charge. I’m happy, but utterly confused. It seems to be telling me “Your insurance policy is shit and covers nothing, but because we are super awesome we got you a deal.” It’s like a car salesman telling me a car costs $30k but then he goes to “speak with the manager” and comes back to tell me that he got the price down to $24k. I don’t end up feeling like my insurance company/salesman is awesome, I end up feeling like the healthcare system/car dealership was ripping me off from the start.
jeffd
3650
Buried in the census report that came out yesterday was some bad news: uninsurance rates (that is, the number of people who go without health insurance) are up almost across the board. The good news? They’re down for young adults. Relative to 2009, a half million more young adults aged 18-24 have health insurance.
Why? Obamacare. One of the first provisions of the law to go into effect allowed parents to carry their children on their health insurance until they turn 26. It seems like lots of people are taking advantage of this.
JeffL
3652
Yep, my daughter who just graduated and has been unable to find a teaching job so far is also now on our insurance.
A woman writes about the slow and painful death of her brother who had cancer and couldn’t afford treatment because he was uninsured and ineligible for Medicare.
To all of those tea-jadist assholes at last night’s GOP debate: I don’t generally like to use profanity, but I fear that English is above your comprehension level, so in terms you might better understand, may God damn your worthless souls to hell for all eternity.
I had not planned on watching the debate because it conflicted with more important activities, like a new episode of The Closer. But even more importantly, it was being held at a time when I had committed to posting a diary for The Grieving Room. That diary was about the death of my brother from a very painful, uninsured struggle against metastatic cancer.
Yeah, well, okay. Sometimes people slowly and painfully die of cancer because they don’t have and can’t afford insurance. But the majority of people don’t, and that’s what I think we should be focusing on here.
I love how the question was phrased in that debate. Oh, we’re not talking about the people who can’t afford insurance–we just want people who totally can afford it but choose not to to die. As if that’s the problem with the system. Insurance is so cheap you guys, so available and affordable, and the problem is these young people would rather spend their money on boomboxes and marijuana cigarettes.
Murbella
3655
It is because the unions are taking too much of their money.
I thought this consumerist article was relevant to some of the discussion that had gone on here.
Surprise! Turns out that even if you want to be a good consumer in a healthcare market you’re likely unable to find out how much your procedure and any aftercare will cost. Some reasonable some… well. There are also a few exceptions thanks to a 5 state level initiatives and 1 federal initiative.
jeffd
3657
Cool bit on how availability of more expensive treatments can drive healthcare costs.
No prostate cancer treatment has been proven superior to the others. There are, however, substantial differences in cost, which are becoming more important to society and are a focus of health care reform in the United States. While there are theoretical advantages to proton beam therapy from a radiation physics standpoint, no study yet has demonstrated its superiority to modern photon-based therapy in terms of either oncologic or quality of life outcomes. To our knowledge, we show for the first time that the availability of a technology, in this instance a proton beam facility, in one’s HRR is associated with a higher likelihood of receiving proton beam therapy compared with those living in an HRR where this technology is not available.
Just another example of why comparative effectiveness needs to become part of protocols. There’s apparently no good reason to use this proton beam treatment over radiation, but it happens anyway.
Interesting thing I found out last weekend. Distant cousin works for Indiana hospitals as a mediator for buying and fixing equipment. GE, Siemens, etc all charge over 3x the normal price for cat scan machines etc to US hsopitals vs. what a dedicated purchasing agent (or Canadian/European healthcare) can arrange. So right off the bat the big players jack op the profit take 3x. GE is the biggest seller and rips hsopitals off the most since they can. When you’re talking about $300,000-$500,000 for equipment plus tech/installation - and now you’re looking at $900,000-$1.5 million.
All the way down the line, from the start with the insurance companies reaping ridiculous profits and raping people for premiums, to the way hospitals do purchasing, corrupt doctors, corrupt lawyers + indidivuals, prescription medicine cost has decimated the everyday American consumer healthcare availability. It’s like a collusion of everything that’s wrong with society dumping on the most important thing in the world… your ability to stay alive and quality of life.
An LA Times columnist has been all over this recently. His kid needed some procedure and the hospital basically had two bills. If he paid out of pocket, it was in the hundreds. If he put it on his insurance plan, it went up to tens of thousands. Hospital figures if you have insurance, it can run up the bill. It was pretty insane.
