PING: Joerg or other medical types

Kaiser doctors are salaried. One of them once told me that nobody can tell him what drugs or treatments he is allowed to provide.

Private doctors who accept insurance often pack their waiting rooms, make people wait an hour or more, and see patients for minutes, maybe palm them off on an assistant. And "code" to the max.

I've never had any questions about things like that, and no bills other than the monthly fee for all our employees, and on the spot co-pays. My co-pay used to be $10, but went up to $25 with Medicare. They waive it if they can call it an annual checkup, which they usually do even if it's not literally true. Followups are sometimes free in no logical pattern.

They do ask if an injury is work related, because I think they can/must report to and sometimes bill the workman's comp system. We pay a crazy amount of workman's comp insurance, which is a state-run mess.

Their eyeglass shop is a ripoff, but most are; I use Zenni.

I don't know what a "group plan" is, but it sound like that's a positive result of "Obama Care".

It isn't that difficult.

Suppose you need expensive diagnostics and/or treatment otherwise you will die, and you don't have any dependents nor relatives.

If the doctor diagnoses and treats you, he has to spend a lot of money that comes off his bottom line.

If he doesn't treat diagnose/treat you, he saves that money and you die. There is no other penalty since there is nobody to sue him.

Group, as in employer paid medical. Long before O'Care, I could change plans at will (during the once-a-year enrolment period). Before O'Care, I did have to show existing/prior coverage when changing employers, though.

Like everything, nothing is free. It's "positive" if you're not paying. Perhaps it's a good idea to be able to insure your house

How does it come off the "doctor's" bottom line? If anything, the problem is just the opposite.

You really are a sick pup.

Such small co-pay deals are not available to individual plan holders. The first >5k/year/person is full out of pocket except for (some) preventative exams.

That was one of the complaints. They said the first eye exam above a certain age is preventative and thus no charge, plus we'd get 20% discount at their eyeglass shop (which was, as you say, still too expensive even with that discount). Shortly thereafter we received a bill that was much higher than the same eye exam would have cost elsewhere. I filed a grievance with the state. They tried to stonewall as usual but I stood my ground until I won. Not because of the money but out of principle, I do not like bait and switch.

That's why some people find a way to get into a real or sometimes fake group plan. But even in a group, premiums increase with age.

I didn't like the prescription from the Kaiser optometrist; he over-corrected my astigmatism, which has happened before. They tend to optimize each eye alone, ignoring the fact that I generally use both eyes simultaneously. I worked out my own prescription and order really nice glasses from Zenni for $22 a pair.

I don't like to fake something. But with this escalating cost since Obamacare I am really tempted to some day reduce my work hours and plop us into one of the subsidized plans. Why bust my behind when taxes and healthcare sap away the disposable income? I'll see whether we get some serious change after the next election. If not I might move some hours from consulting to volunteering, mountain biking and beer brewing.

We ordered some nice bifocals via Amazon. They came in 0.25 diopters granularity. Regular around $35 but on sale they were under $20. But it's hit and miss, when there is a sale they don't have all the sizes and diopters available.

We've been on Medicare plus a Mutual of Omaha supplemental for 11 years, so NO co-pays except for prescriptions... which can become treacherous...

Wife went into the so-called "donut-hole" this past year, so Rx co-pays for last few months have been ~$400/month :-(

Our total annual premiums (Part B + Part D + supplemental) totaled $8716.92 ...Jim Thompson

Ouch! That is not much less than what we pay for health care per year. Except we have huge deductibles.

The deal Kaiser offers Medicare people sounds much better. AFAICT there is one plan with no premium where the drugs cost more and then one around $100/mo or so where they cost less. For folks like us who do not need many prescriptions (except when I crash the mountain bike into poison oak) the first plan should work. But I have no clue how all this part A, B, C, D stuff works because I am not there yet.

I wonder what people with only social security income do. They'd financially drown. Plus get taxed out of their homes.

Can you get real group plans through your Engineering society or whatever professional organizations you're a member of?

I'm always getting offers for supplemental insurance from those guys- probably P.Eng/ PE have a lower risk profile than the public at large.

--sp

Fortunately, we have NO deductibles.

Before "retirement" I was paying ~$850/month premiums plus co-pays plus $5K deductibles :-(

Arizona freezes value of homes if you're a senior with below a certain income level... plus this ain't no Californica... my real estate taxes are ~$1600/year >:-} ...Jim Thompson

OK, so that is a reasonable way or minimising the problem since the scheme has both many members and young fit members.

If you aren't in that lucky position and you have to choose a plan, I presume the insurance company isn't going to give you the critical information before you join.

Oh, my medical care isn't free. But, whatever my age, it does cost me about 1/3 of the amount a young person pays in the US.

Bloody good value for money, and bloody good care too. (Although getting worse now that "market reforms" and "competitive tendering" are being introduced", and commercial interests are cherry-picking services.

Not very sick, yet. Although it is becoming apparent what will kill me.

Not anymore. IEEE used to offer health plans but they soon spiraled out of control costwise.

In Canada? That's surprising. I don't get those offers anymore and in the old days whenever I inquired they were either underwritten or outlandishly expensive. The underwritten ones always bumped us off because a large chunk of our health history is out of country and in another language. Because of that years of literally "no claim" meant nothing, just like they didn't for auto insurance where in the first few years I had to pay novice rates despite lots of miles and no accidents.

The health "system" in the US was always sick and after Obamacare it became much more sick.

That's roughly what we are paying right now and the $5k is per person/year. But being quite healthy we don't use much. I'd really like to have a catastrophic-only plan but Obama won't allow that.

Lucky you. It's $4k here :-(

I'd move to Utah or some other place where there is prime mountain bike turf and no leftists in power for the next 2-3 decades. But I really do not like moving.

It's quite reasonable. So reasonable that it's illegal to do it, unless you're an employer. Also something O'Care wants to get rid of.

There is no luck involved. If you *choose* to be without such benefits you would probably choose the lowest cost insurance that will have you. It will likely be the one with the best pool.

Nonsense. You're just not "seeing" the whole picture.

Heavens! Can't have CHOICE! That would be too much like freedom. Only the Politburo is allowed a choice, right?

You obviously haven't a clue.

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Health care works best when run as a gigantic welfare program. What every r ight-wing commentator refuses to pay attention to is the fact that the main job a of health care system is to prevent epidemics. The job of looking af ter non-epidemic disease is what society pays as a bribe to get people to g o to the doctor when they get sick.

If they've got an infectious disease they can be whisked into isolation bef ore they infect too many other people. The advanced industrial world has go t good enough health care that we very rarely see epidemics, and people com plain like fury about the costs of preventing a potential epidemic - as in all the vaccinations against swine flu, that worked.

The US already came close to getting an epidemic of drug-resistant TB when their crummy system didn't pay enough attention to keeping the poor taking their anti-TB drugs until the infection had been fully cleared, but people like James Arthur who ought to know about that and appreciate the lesson ar e still mad keen to have everybody taking responsibility for their own heal th care, when any realist knows that health care gets skrimped faster than pretty much anything else, because skrimping there doesn't usually cost you anything.

Nice idea, as long as you can guarantee that they won't catch something inf ectious, and become responsible for your ill-health.

The trouble is that you want them to go to the doctor to complain about all kinds of symptoms, because some of those symptoms are of infectious diseas es. Demanding antibiotics where they won't do any good is stupid behaviour, but charging people money to stop them doing that, stops them from going to th e doctor when it would be less stupid to do so.

Carrot and stick is fine, but you do have to keep in mind the whole situati on, not just the example that gets up your nose.

I think it's her heartbeat (BPM). Someone was slightly upset at first, and then calmed down a little---seems legit :)

Best wishes for your wife's speedy recovery

There's a tremendous difference in culture between various Kaiser facilities, all the way from 'excellent' to 'don't bother me, I'm drinking coffee.'

Yup, exploded school loans & loan debt, too. (HCERA, the Health Care and Education Reconciliation Act of 2010, part of O-carp.)

Cheers, James Arthur

No, it's the old system. A group plan is when a group of people, usually a company, apply for a plan.

It's even better in a government system: nobody cares whether you live or die, and they've got immunity from suit.

I heard a big healthcare CEO recently point out that the U.S. actually spends the same per capita as Europe, up to age 62. After that, we spend a whole bunch more, accounting, he said, for the entire difference.

Cheers, James Arthur