We use Kaiser Permanante as our company health provider. There is a fixed fee per month per employee for total health care. No forms, no claims, no denials, no restrictions, no 3rd party payers. It's superb.
Kaiser is owned by the physicians who work there; they are all salaried. My doctor pesters me to stay healthy. If she thinks I need a shot or an xray or a blood workup or an a LN2 spray (cured my skin cancer in 30 seconds!) she gets it done on the spot.
The ACA specifically forbids the creation or expansion of such organizations. That's one of the sellouts to the insurance industry.
The peoples representatives have got staff to read legislation - presumably enough staff that they can divide up long bills and get separate members o f staff each to read separate sections in parallel.
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Democrats aren't automatically fools, and more than the average Republican is as daft as Donald Trump. The Supreme Court didn't actually say that Obam acare couldn't be undone, but rather that the claims that it was unconstitu tional were invalid, which isn't quite the same thing.
In James Arthur's somewhat bizarre opinion.
Representative government has always been government by a handful of rulers .
Even classical Greek democracy, where you could get all the voters together to vote on particular issue, devolved day-to-day power to a limited number of executives who could spend their time keeping on top of what was going on.
The 1788 US constitution takes into account that the representatives had to get together in Washington to work out how to run the country. The problem with the US is that the US constitution was devised to allow the people th at owned the country to have considerable influence on how the country was run, while presenting enough of a veneer of representative democracy to kee p the cannon-fodder happy.
Posting opinions that you don't share isn't evidence of a lack of critical thinking skills - in fact posting opinions that you do share could be evidence of precisely such a deficit.
It's open enrollment. In order to try to make heads or tails of the differe nt Anthem plans I made a graph.
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The gold plan only makes sense if you get someone else to pay the premium.
The silver falls the lowest for the range of yearly health care costs betwe en $4000 and $13000. You don't break even on your premium + deductible + pe rcentage until about $12000.
The difference between the premiums of the bronze is negligible and of thos e the 5150 deductible, 25% is usually the lowest. Since my health care cost s will usually be zero that's probably my best choice.
Max Out of Pocket is a lie. It's only the maximum for covered costs. So if you need a medical procedure, the doctor/hospital sends you some bills, the insurance company says we only pay so much for this procedure, and you're stuck with the difference. This stuff isn't listed anywhere.
You may be reading that wrong. Often insurance companies will contract with their "network" to provide coverage for that cost and that's all they will cover. By contract, the insured pays only the copay, deductible, or whatever. The provider cannot charge more. Example, in the last year I've gotten bills for ~$300K and they've paid ~$100K, while my out of pocket was essentially nothing (under $1K). My granddaughter is essentially the same, except that the numbers were about double that and the out of pocket was somewhat higher (their insurance wasn't as good). Everyone got paid and everyone is happy.
The dermatologist sprayed a dark spot twice over two years, then next visit decided he should do a biopsy. The result, the area had been frozen! I was in another time and ask is there something I can put on different dark area to lighten it, the dermatologist grabbed her little bottle and sprayed $105.00 on it. just made it darker, I ask for my money back, and got it. What a racket. Mikek
Kaiser has a "roving dermatologist" who, I guess, walks around with his spray bottle. Any MD can text him and he'll usually show up in minutes and blast away. That's free. Dermatologists are among the hardest doctors to get to see in traditional insurance plans.
You can self-treat some things with freeze-spray.
K also has some on-call psychiatrists. If you confess to any sort of depression or anxiety or whatever, they send you down there to have a talk.
Insurance is deliberately obfuscated. You probably won't understand it until you use it, if then. I still can't figure out what my "deductible" is for. It makes no sense to me. The deductible seems to only apply to the copays (and $5000 goes a long way at $20 a pop).
I like Kaiser, and have seen it from outside and in. Not efficient, but good and workable. Good patient care, if you know how to work within their Borg. There's an enormous variation between locations, in service, quality, and culture.
They were also the highest-priced insurance plan in California's market when California's CoveredCA slave-market^H^H^H^H^H^H^Hinsurance exchange opened, FWIW. I haven't followed it since.
Obamacare's Gruber praised Kaiser, lamenting that Kaiser has tried expanding their model across the country, but simply can't find enough physicians interested in that salaried, quasi-stultifying (to some), bureaucratic work environment.
It's one of the reasons Kaiser Permanente was & is a major supporter of the UnAffordable Act, too. Rather uncharitable of them, IMO.
tween $4000 and $13000. You don't break even on your premium + deductible + percentage until about $12000.
hose the 5150 deductible, 25% is usually the lowest. Since my health care c osts will usually be zero that's probably my best choice.
if you need a medical procedure, the doctor/hospital sends you some bills, the insurance company says we only pay so much for this procedure, and you' re stuck with the difference. This stuff isn't listed anywhere.
Wanderer may be referring to a new Obamacare plague: you go to your 'in-network' doctor at your 'in-network' hospital for an operation, then get a huge bill afterward for going out-of-network because the anesthesiologist whom you never spoke to--who appeared while you were unconscious and laid open on the operating table--was out-of-network.
Just happened to an Obamacare-insured friend of mine. Thanks Obamacare!
(Can also apply to drugs. Need an expensive chemo drug? Sorry, it's not on the 'formulary'--your plan doesn't cover *that* one. But there's good news--poltices and leeches *are* fully covered!)
between $4000 and $13000. You don't break even on your premium + deductible + percentage until about $12000.
those the 5150 deductible, 25% is usually the lowest. Since my health care costs will usually be zero that's probably my best choice.
o if you need a medical procedure, the doctor/hospital sends you some bills , the insurance company says we only pay so much for this procedure, and yo u're stuck with the difference. This stuff isn't listed anywhere.
Seems bizarre. Is your Obama-insured friend one of those climate-modelling friends of yours, who couldn't get their own models to work and decided tha t every body else in the climate modelling business had to be equally incom petent and were thus lying about their more successful models?
You might want to check out their story in more detail.
All health systems have a tendency not to include the more expensive chemot herapy drugs in the list of approved and supported pharmaceuticals. Some of them are very expensive indeed. The lists of approved and supported pharma ceuticals does tend to extend well beyond poltices and leeches (not that me dically certified germ-free leeches are all that cheap).
Dr B (they call him B because nobody can pronounce his Thai name) saved my retina in the OR at 10 PM. He is brilliant and has probably saved the sight of thousands of people. He wants to fix eyes and doesn't care about money.
I can imagine that Kaiser has a hard time finding more people like that.
s between $4000 and $13000. You don't break even on your premium + deductib le + percentage until about $12000.
of those the 5150 deductible, 25% is usually the lowest. Since my health ca re costs will usually be zero that's probably my best choice.
So if you need a medical procedure, the doctor/hospital sends you some bil ls, the insurance company says we only pay so much for this procedure, and you're stuck with the difference. This stuff isn't listed anywhere.
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g friends of yours, who couldn't get their own models to work and decided t hat every body else in the climate modelling business had to be equally inc ompetent and were thus lying about their more successful models?
Is your memory really that poor? You've gotten every fact wrong.
The gentleman in question worked for the U.S. government, on one of the mod els you rely on to extrapolate your climaclysmic conclusions. He reported sever al critical failings that invalidate such conclusions, all of which were confi rmed a few years later in the literature, then discussed here.
You mean she doesn't know, somehow, that she has Obamacare, but got a huge bill? That's your thought process? Really?
Of course she knows. You just don't care.
Here, from your fellow healthcare fascists:
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--quote-- "Suppose you go to get a colonoscopy and the anesthesiologist is out-of-network, which is a very common story that we get. We often see a patient will be balance billed like two or three thousand dollars for anesthesiology services," Bell explained.
--/quote--
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--quote-- The New York Times' Elisabeth Rosenthal offered an important lesson in heal thcare economics over the weekend that's a must-read for anyone about to un dergo a major medical procedure.
Rosenthal's piece explored how charges from out-of-network providers can ma gically show up on a hospital bill. She focused on one particularly nasty p ractice, called "drive-by doctoring," in which physicians call in colleague s not in a patient's network to consult or assist on a procedure.
--/quote--
But these are only facts, don't let them cloud your opinions. :-)
So if you need a medical procedure, the doctor/hospital sends you some bill s, the insurance company says we only pay so much for this procedure, and y ou're stuck with the difference. This stuff isn't listed anywhere.
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Yep. It's just gotten a lot worse, because the new "networks" are so limite d, and Obamacare has (already) almost eliminated the more popular PPO plans.
PPO plans (when they roamed the earth freely like the dinosaurs, in 2014) cost more, but let you go anywhere you wanted. Under Obamacare insurers are wiping those off the map, because they attract sicker patients.
We now have a perverse competition wherein insurers work to (must?) guarantee their plans will be less attractive to sick people than their competitors' plans. IOW, least attractive to the people who need them most .
It's like a free market trying to deliver what customers want and need, inverted.
I think a lot of doctors are like that, but they hate, hate, hate all the bureaucratic politically-correct baggage. They just want to be doctors.
Some surgeons over in Oklahoma got sick of all the hospital b.s., set up their own surgery center, and do the same work they did at the hospital, for 1/6th the price, cash. Prices on the web.
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They call it "honest pricing." That's how it should be. I've spoken to the founder--great guy. Libertarian humanitarian.
If these catch on costs will plummet and Obamacare will be irrelevant.
My GP is like that. He refuses to work for a hospital. For a while the hospitals were buying up all the independent doctors (one bought my cardiologists practice) because O'care made such a mess of things. If he can't stay independent he'll just shut down the practice. His backup plan is drug rehab (he's a director on several boards).
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