General Discussion

Fumesucker

(45,851 posts)

64. I'm kind of the go-to person among some of the people I know for news type info

Tue Mar 18, 2014, 11:34 PM

Mar 2014

People in my real life are asking and saying things like this, at least the ones who can breathe through their noses.

I guess my point is that what plan you pick depends on your health and the ones for the less healthy are going to be more expensive or I'll be quite surprised.

The whole idea behind insurance is to get the largest risk pool possible to average out the bad luck with the good and this seems to defeat the very purpose of getting a large risk pool.

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Don't be deceived. Contrary to popular opinion, ALL insurers, whether on or off the exchanges, [View all] pnwmom Mar 2014 OP

But some think that Obama's worse than a used car salesman, or some shit like that. :eyes: NYC_SKP Mar 2014 #1

Yeah I know. I thought I should put this out there where hopefully more people will see it pnwmom Mar 2014 #5

I agree. Texasgal Mar 2014 #9

But it is a start. And millions are already better off. We just have to be as smart as we can pnwmom Mar 2014 #11

And we have to be vigilant about fixing the problems with it, we can either strengthen the ACA and okaawhatever Mar 2014 #29

how are you going to fix the fact that big insurance takes 20% or more? Doctor_J Mar 2014 #59

By killing big insurance. jeff47 Mar 2014 #66

this has to be some sort of joke Doctor_J Mar 2014 #68

You're free to point out where that plan won't work. jeff47 Mar 2014 #72

How did we give insurance companies 600 Billion dollars? nt okaawhatever Mar 2014 #108

The US HC industry is now 3 trillion per year. The ACA guarantees them 20% that JUST FOR PROFIT Doctor_J Mar 2014 #124

Did You Do It? ProfessorGAC Mar 2014 #139

er, not if there was a public option Doctor_J Mar 2014 #146

I prefer single-payer, but I don't think we should be spreading lies about the ACA here pnwmom Mar 2014 #149

Administrative costs ARE NOT PROFIT. pnwmom Mar 2014 #144

And a 5 million dollar bonus for a HC CEO is not health care Doctor_J Mar 2014 #148

Wrong. It's part of administrative costs. I don't agree with a bonus like that, but the insurer pnwmom Mar 2014 #150

So part of my new $50 copay goes toward the CEO's fifth home, legally Doctor_J Mar 2014 #185

Switch insurers if you don't like yours. n/t pnwmom Mar 2014 #188

To another whose CEO has six houses? Fantastic Anarchist Mar 2014 #192

If that's what you prefer. n/t pnwmom Mar 2014 #193

Well, I guess I have a choice everyone's talking about then. Fantastic Anarchist Mar 2014 #194

It *LIMITS* them to 20%. It used to be however high the fuck they could make it. You'd prefer that?? yodermon Mar 2014 #153

In return for every person in the US being a paying customer Doctor_J Mar 2014 #190

Considering that was a reduction in their profit, I'd say that is a win. Also, the 20% isn't okaawhatever Mar 2014 #105

I don't know where to start Doctor_J Mar 2014 #125

Ted Kennedy's death changed everything. He was replaced by a Rethug in MA pnwmom Mar 2014 #151

Not true. pnwmom Mar 2014 #141

They don't. Large insurers must keep administrative costs below 15% pnwmom Mar 2014 #142

Ok, 400 billion instead of 600 billion Doctor_J Mar 2014 #186

You're been pretending that all 20% is profit, which is blatantly untrue. n/t pnwmom Mar 2014 #187

I consider 10-figure CEO bonuses profit. Doctor_J Mar 2014 #189

Then switch companies. n/t pnwmom Mar 2014 #191

Would love to. Can you point me to the one with 3% overhead like Medicare? Doctor_J Mar 2014 #195

They were taking much more than that before. nt brush Mar 2014 #180

Right.. like Raging Misplaced Anger would help solve the problem. That Cha Mar 2014 #12

what that sounded like is someone didn't do their homework Whisp Mar 2014 #16

Exactly.. same with this one.. Cha Mar 2014 #18

And a beautiful arc it is, JEB Mar 2014 #63

There is also this: ProSense Mar 2014 #2

Thanks, ProSense! That's important for people to know about. n/t pnwmom Mar 2014 #3

That was the deal pre reform, at least in the majority of policies. TheKentuckian Mar 2014 #104

What gets me is a single payer system might also deny certain treatments or drugs treestar Mar 2014 #120

Right. Canada and the UK have single payer with formularies. pnwmom Mar 2014 #162

Where have you been? malaise Feb 2017 #197

yeah, i wanna know too. mopinko Feb 2017 #198

The upshot of this being what? Fumesucker Mar 2014 #4

The upshot is that you shouldn't give up before checking out the drug formularies pnwmom Mar 2014 #8

Just to be clear, it won't cost more for your coverage if you have an expensive disease? Fumesucker Mar 2014 #13

More doctor visits and more medicines to buy = more money to be paid. Lex Mar 2014 #27

They can't charge you higher premiums because you have an expensive disease. pnwmom Mar 2014 #28

"no insurer can fail to provide appropriate medication for whole categories of illnesses" Fumesucker Mar 2014 #41

It means that they might be able to tell you, if you need an aromatase inhibitor, pnwmom Mar 2014 #44

An aromatase inhibitor is an aromatase inhibitor? Fumesucker Mar 2014 #51

Some people might. Some people might with any drug category. n/t pnwmom Mar 2014 #54

Been on them 9.5 years. Lars39 Mar 2014 #60

Unfortunately, formularies aren't something specific to the ACA. Medicare has a formulary, pnwmom Mar 2014 #140

Formularies should be standard from company to company. Lars39 Mar 2014 #143

Each company negotiates prices with the drug companies. There's no universal pricing. pnwmom Mar 2014 #145

And that is why we are sitting ducks. Lars39 Mar 2014 #147

Medicare and Medicaid use formularies. So do the national health systems pnwmom Mar 2014 #161

Making formularies standard from one ins co to the next would cut costs, ie profit. Lars39 Mar 2014 #165

It would also give people fewer choices. As it stands now, if one insurer doesn't cover your pnwmom Mar 2014 #167

It is not set in stone that it would have to be that way. Lars39 Mar 2014 #168

Please name one single-payer system anywhere in the world that doesn't have a formulary pnwmom Mar 2014 #169

That does not mean that we could not have the improvements. Lars39 Mar 2014 #170

Of course. Everything could be improved. But we need to be clear on what the issue is. pnwmom Mar 2014 #171

Er, yes, it is. What would be one more law or three that insurance companies Lars39 Mar 2014 #173

The ACA could be amended, yes. But the ACA didn't invent formularies, pnwmom Mar 2014 #175

formularies is how we can reduce drug prices. you use them to mopinko Feb 2017 #199

but for MS drugs... blindersoff Mar 2014 #160

No, it isn't. If a brand name is the only standard treatment, then it's supposed to be covered. n/t pnwmom Feb 2017 #201

Should all pills be free? theboss Mar 2014 #164

that people having issues with insurance companies have to fight them and shop around geek tragedy Mar 2014 #15

Just to be clear, it won't cost more for your coverage if you have an expensive disease? Fumesucker Mar 2014 #21

"everyone pays the same" geek tragedy Mar 2014 #25

All else being equal, the expensive patient pays no more for coverage? Fumesucker Mar 2014 #34

you're asking a question as if you know the answer. geek tragedy Mar 2014 #37

It's cuter, I guess, if he asks the question 12 times first. nt Lex Mar 2014 #40

Do we all have to be insurance experts now? Fumesucker Mar 2014 #46

as in all things, the more you know the better off you'll be geek tragedy Mar 2014 #50

You don't need to know your coworker's income Fumesucker Mar 2014 #58

Premiums for the same plans are the same for all customers, regardless of health, pnwmom Mar 2014 #47

I'm kind of the go-to person among some of the people I know for news type info Fumesucker Mar 2014 #64

There are no plans for the less healthy jeff47 Mar 2014 #71

In other words everyone has to become insurance experts Fumesucker Mar 2014 #73

Not nearly as hard as you are claiming. jeff47 Mar 2014 #75

Just finding out what you actually have can take a very long time Fumesucker Mar 2014 #78

K, that means you'll be in the latter group. jeff47 Mar 2014 #79

And if the symptoms return? Fumesucker Mar 2014 #83

Then you deal with it in your chosen plan for the rest of 2014. jeff47 Mar 2014 #93

I'd start by calling up your primary care doctor and ask what plans they take. pnwmom Mar 2014 #100

Not really. Everyone who has a doctor already should ask the doctor pnwmom Mar 2014 #99

Prepare to be surprised then. That is no longer how it works. This is the whole point of getting pnwmom Mar 2014 #98

Or as if there is any possible system that might not deny coverage treestar Mar 2014 #121

Post removed Post removed Mar 2014 #6

Of course not. I'm saying don't give up if the first company you look at doesn't offer what you need pnwmom Mar 2014 #10

"I LOATHE Obama".. well, aren't you a special little piece Cha Mar 2014 #14

Tell us how you really feel?! flamingdem Mar 2014 #20

Just responding to a perfect example of ODS.. Cha Mar 2014 #31

hola! I just posted the jury results down below, here they are flamingdem Mar 2014 #36

Aha! One and Two need to pay attention to #3. Cha Mar 2014 #43

You know, I have heard that sentiment in the flesh so many times nadinbrzezinski Mar 2014 #23

The Jury results are in... SunsetDreams Mar 2014 #45

Brawawawaaaaaaa.. I thought you were going to give me the results of Cha Mar 2014 #57

LOL SunsetDreams Mar 2014 #62

And, that wasn't all he had to say.. Cha Mar 2014 #69

I'm surprised Jamaal510 Mar 2014 #123

Thank you for the reminder that some people lie when they say they geek tragedy Mar 2014 #17

Precisely geek. Haters gonna hate and a perfect example of ODS. Cha Mar 2014 #30

Well, now s/he's been unmasked. pnwmom Mar 2014 #49

thank you for that valuable INFORMATION Whisp Mar 2014 #7

FYI, some conditions will hardly be in standard formularies nadinbrzezinski Mar 2014 #19

The insurance companies know damn well a lot of people aren't going to do that Fumesucker Mar 2014 #26

And the time involved can wipe out your savings Lars39 Mar 2014 #35

Well face it, they are the little people zeemike Mar 2014 #74

So true. Wait, is this where I'm supposed to Lars39 Mar 2014 #77

Talk about adding insult to injury, just to defend Obama SammyWinstonJack Mar 2014 #177

Even under a single payer system, like Medicare, there can be formularies. pnwmom Mar 2014 #38

Yes, but I am not talking Medicare, or tricare, the closest we get to nadinbrzezinski Mar 2014 #42

I wonder if they use formularies in Canada? Anyone know? pnwmom Mar 2014 #48

Everybody does nadinbrzezinski Mar 2014 #52

Yeah, he's definitely better off there. I was also reading something recently pnwmom Mar 2014 #56

And Italy. nadinbrzezinski Mar 2014 #61

Spend some time in an Italian hospital before you boast about how great they are. MADem Mar 2014 #106

i meet w people every week at hospice that deny your claims. mopinko Feb 2017 #200

Of course they do. If you haven't nationalized pharma you have to have a formulary Recursion Mar 2014 #55

+1 treestar Mar 2014 #122

They can't dump you when you get sick but can deny life-saving meds? Skip Intro Mar 2014 #22

Like Medicare, they can't deny all standard medications for any particular condition pnwmom Mar 2014 #33

Thank you for this good advice, pnwmom.. Valuable Things to know about your Cha Mar 2014 #24

Glad that DU in the grand majority supports the ACA and the HUGE efforts on the part of Obama flamingdem Mar 2014 #32

Thanks for posting this. I can't even stomach what some people write. It says absolutely nothing okaawhatever Mar 2014 #39

Brokers are all out to sell, sell, sell JEB Mar 2014 #53

I just signed up for my plan at work and noticed the preexisting small print sir pball Mar 2014 #65

That doesn't sound right. Lars39 Mar 2014 #70

My plan MAY be grandfathered. sir pball Mar 2014 #80

According to that link, the only grandfathered plan Lars39 Mar 2014 #82

Well either the link is wrong or Blue Cross/Blue Shield is. I honestly think the former. sir pball Mar 2014 #95

Darn. A bit more complicated than I thought: Lars39 Mar 2014 #86

ACA Guidance on 90-Day Waiting Periods and Certificates of Creditable Coverage jtuck004 Mar 2014 #87

As I said, I think I have a "preexisting plan" sir pball Mar 2014 #96

Which is nice, until people see that MONSTER deductible that has to be met davidn3600 Mar 2014 #67

I know what you mean, but a lot of PEs are incredibly expensive anyway sir pball Mar 2014 #81

There are co-pays along the way. You don't pay 100% out of pocket until you meet the deductible Lex Mar 2014 #84

Who the hell reads formularies? progressoid Mar 2014 #76

who reads formularies? geek tragedy Mar 2014 #85

Caveat emptor Fumesucker Mar 2014 #88

yeah, telling people to get the best information possible is exactly geek tragedy Mar 2014 #90

But this is the reality you were replying to Fumesucker Mar 2014 #92

navigating bureaucracy is a challenge geek tragedy Mar 2014 #94

Single payer systems have formularies, too. And you can't switch to another single payer system pnwmom Mar 2014 #157

It's not ok, but they'll do it, given half a chance. nt cyberswede Mar 2014 #91

You and...? progressoid Mar 2014 #102

Lots of people pay rapt attention to something that so vitally affects them. Cha Mar 2014 #89

And lots of people don't. progressoid Mar 2014 #103

Lots of People do. Cha Mar 2014 #109

And the people who don't, get fucked. progressoid Mar 2014 #111

And, the people who do get saved. Cha Mar 2014 #113

So, it's survival of the best insured. progressoid Mar 2014 #115

Should you have no role in your healthcare decisions? theboss Mar 2014 #166

Anyone who needs an expensive drug and can read a list of drugs. pnwmom Mar 2014 #101

So, progressoid Mar 2014 #107

Insurers can't not include whole classes of drugs. So if you can't continue on one diuretic pnwmom Mar 2014 #112

"next December you can look for an insurer with a better formulary" progressoid Mar 2014 #114

Canada has a drug formulary. The UK has a formulary. I'm not aware of any single payer pnwmom Mar 2014 #116

Anyone who needs a hugely expensive drug should. That should be a key factor, pnwmom Mar 2014 #158

More light, less heat. Thanks a bunch, pnwmom. nt Hekate Mar 2014 #97

Thank you for injecting a modicum of sanity into the "discussion du jour." MADem Mar 2014 #110

+a million Number23 Mar 2014 #117

Yeah, I think that was the Fonzie Moment for that fellow. MADem Mar 2014 #118

Absloute projectile vomit--and on the second thread, since the OP was locked out msanthrope Mar 2014 #172

Good information treestar Mar 2014 #119

Maybe instead of convincing DU to clap louder... vi5 Mar 2014 #126

What do you have against facts? I mean ProSense Mar 2014 #127

Because we know about the ACA. vi5 Mar 2014 #128

Evidently, ProSense Mar 2014 #129

My point is... vi5 Mar 2014 #130

The issue ProSense Mar 2014 #131

Got it. vi5 Mar 2014 #132

Sign-up is still ongoing. We need to counter with facts when people spread lies. Even here. n/t pnwmom Mar 2014 #136

"WE" do not know. A heavily recommended post yesterday, by a smart and informed DUer, pnwmom Mar 2014 #134

This isn't about votes. This is about not scaring people off with only 10 days left to sign-up. pnwmom Mar 2014 #133

They should run on turning the ACA into single payer or better:-) grahamhgreen Mar 2014 #137

Can you help will Pitt get his meds? grahamhgreen Mar 2014 #135

I think he knows in the cold light of day what he needs to do. pnwmom Mar 2014 #138

Yeah... We need single payer or better still. grahamhgreen Mar 2014 #154

Hopefully Vermont will successfully lead the way, pnwmom Mar 2014 #156

I asked if he had tried the National MS Society ... JoePhilly Mar 2014 #176

in the northern part of my county only ONE provider accepts ACA plans.... mike_c Mar 2014 #152

That is a real problem, unlike some of the lies being told around here. pnwmom Mar 2014 #155

I want to commend you...I really do... Phentex Mar 2014 #159

Thank you, Phentex. I have the same basic attitude you do. The ACA has a lot of flaws pnwmom Mar 2014 #174

Thank goodness for insurance companies... LanternWaste Mar 2014 #163

I guess you have never picked a company only to have them stop carrying the meds you use Mojorabbit Mar 2014 #178

No, it's happened to me, on a large group plan. And it happened to my mother-in-law on Medicare. pnwmom Mar 2014 #179

Yes there is an appeal process. Mojorabbit Mar 2014 #181

But this has nothing to do with the ACA. It's the same way single payer countries pnwmom Mar 2014 #182

I am on medicare with a drug plan through united Mojorabbit Mar 2014 #183

That's a larger issue, however, unrelated specifically to the ACA ,and it applies to Medicare, too, pnwmom Mar 2014 #184

Thanks for the work, the info, and for the example! nt LAS14 Feb 2017 #196

2014 post. I was hopeful till I saw the date. riversedge Feb 2017 #202