PING: Joerg or other medical types

My normal resting heartrate is under 60, usually around 55, and frequently below 50. It's been that way for at least 30 years, probably since birth.

I'm asyptomatic, have gone from 0ft to 11.5/12kft in 4 hours and have not noticed effects. Mind you, my heart is slightly enlarged and my blood pressure nicely controlled by drugs.

Which insurance do you have? Since Obamacare made everything else unaffordable we have a high-deductible plan which would have docked us slightly north of $5k out-of-pocket for something like that. Ok with me but considering that we pay around $10k in yearly premiums for two people while subsidizing the welfare plans that's expensive.

I have Kaiser, but they took me to SF General, which is the best trauma center. If I'd gone to Kaiser, they would have charged me $25, once. General sent me scores of unintelligable statements and threats, and it was a moderate nightmare to get medicaire and Kaiser to pay the bills, really to figure out the bills.

The care at General was superb. The food was inedible, but I wasn't very hungry anyhow. General called a couple of times for QC feedback. I told them to tell the nurses to not make jokes around people with broken ribs.

My Kaiser, with a supplemental drug plan, costs me $78 a month, and Medicaire recently went up to $300 or so, because I still have income. Co-pays are $25 a visit, but sometimes they are free. Drug costs are nominal.

I know people who have formed fictitious companies to get into Kaiser at the group rate.

It's insane that Obamacare specifically forbade the startup of additional Kaiser-type (doctor owned) true-HMO plans.

Real insurance is still available to large groups. My insurance is similar to John's. The billing for Sept-'14 thru March-'15 was over $250K, of which the insurance company paid about $100K, and I paid less than $750. Basically, I pay $250 to be admitted to the hospital, $75 for an ER visit, and $20 for an office visit (specialist or GP). The insurance then pays whatever else they decide is "reasonable".

We have Kaiser but would pay 500/day just for the hospital bed, plus whatever procedures cost up to something above $5k/year/person where the plan's out-of-pocket cap kicks in.

$300 is dirt cheap these days.

Wow, I didn't know you were over 65. I am not so I must pay full brunt. The only way to make that afordable (if one would call $10,000/year affordable) was to take the highest deductible possible and pick a plan that Obama could not destroy.

I know people who have quit working to be able to plop themselves into a fully subsidized Obamacare plan, a.k.a. welfare.

I sure hope we get a better president and that whole mess gets repealed.

That can only be had if you are employed at a big company or if you own one. Dems do not like self-employed people so we got the shaft with Obamacare.

Sure, the parent company is big enough, however John's company isn't huge and he seems to have similar insurance coverage.

Yes, the little people get screwed by obamacare. Isn't that what the Dem's mean when they say they *love* the little people?

But it seems he is already on Medicare. That takes a big chunk of cost out of it. His company isn't small, I've visited them. They have a whole factory building in the middle of S.F.

John looks much younger than 65 so I was surprised he could get Medicare.

I never believe them. Just like people felt lied to by the president when he said that they can keep their health plans if they like them. Or when dems said the big tax hike here in CA is temporary. That was a big fat lie but voters fell for it.

I think we should have a network of free-or-cheap neighborhood clinics staffed by nurses, to take care of routine stuff and refer the serious ones. Maybe WalMart will get there first.

In California the unions will waltz in there in no time, every nurse makes more than engineers and then it's all over.

It's a Moonbeam-dominated problem. Such "clinics" already exist in virtually every drug and grocery store here in Arizona. ...Jim Thompson

Of course, there are very pleasant sedation methods:

Is it Medicare or his group insurance (it has to be one or the other)? If it's Medicare, it's a policy open to any Medicare recipient. It would be good if John made it more clear. The fact that he has a "whole factory building in the middle or S.F." doesn't mean that he's not still a small business. He certainly doesn't have $100B in sales.

...and the Republicans who said they'd cut off its funding.

I was on Kaiser and, at my age, it was getting expensive. At 65, I signed up for Medicare, but I'm still in the Kaiser system, same doctor and all. I don't know how that works, but the price dropped over 2:1. The company still pays.

K is a real HMO; they do whatever you need for a fixed monthly fee. No claims, no disputes, no permissions, no forms to fill out, hardly any wait in the waiting room. The doctors are salaried and aren't rushed. Their computer systems are great, and I'm encouraged to email my doctors. They mail me drugs. My eye guy is a genius who has saved the eyesight of thousands of people, including me. He makes us tea and we talk about lasers and stuff.

Obamacare made it illegal to start up any more Kaisers.

Industry SOP; note how each step is simple, obvious, beneficial to the insurance company, and the net result on the person - each company has many plans - each plan is financially ringfenced from the others - join any plan, take a medical, existing conditions are excluded - decades later the company brings out a new plan with lower premiums or better payouts - anyone can leave a plan and join the new plan, but they must take a medical and existing conditions are excluded - the fit and healthy switch, leaving the rest in a smaller plan - since the plan is ringfenced, the premiums rise *significantly*

Thus the provident - but unfortunate - get screwed when they are most in need.

I remember a long NPR programme noting that a typical premium increase later in life was from 2000 to 18000. That's significant.

(For comparison, at that time I was paying around 600, and there were no payout limits)

So, what's to prevent the doctors skimping on diagnosis and treatment, and pocketing the money? One thing and one thing only: the fear of being sued.

Tough luck if you don't have any competent dependents: doctors bury their "mistakes".

That was never the case with group plans and, of course O'Care got rid of it for others. Life insurance still works that way, though.

In theory, the doctor has no financial interest. There may be pressure from above, however.

Huh?

Ahm, not quite. I had several and all related to gross overcharges. Cases where member services clearly told us something was covered as preventative and then we got a big bill from them. To the point where I found that deceptive. It took some major investment of my time and some legal measures to get that corrected.

Member services is one of the parts of Kaiser that is not running well at all. Worse than Blue Shield was in the old days.

Not quite either. We just got a questionaire to fill out for a wrist break over two years ago. It was clearly an accident just like your stair fall. Looks like they want to try everything to see if they can sue someone. I find that a little less flattering.

Yup. Obamacare destroyed a lot and more than health care. It needs to be repealed.

It's no different than an automobile accident. The insurance company will make sure they're the appropriate pocket. It could also have been covered by someone's liability insurance, for instance. I don't see an issue with that at all.

It won't be.