Local news on Obamacare from the CEO of the Cleveland Clinic

Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: titleist1 On: Tue Apr 01, 2014 11:29 am

It is curious to me that zip codes now have such a drastic affect on health insurance rates. The insurance companies could have always charged more based on zip code, but they didn't have to because they had other direct health related metrics to determine rates and coverage. Now that zip code is one of only three factors allowed for determining rates it becomes a huge influence. It doesn't cost any more to prescribe a med today than it did 3 years ago in East BippeeJippee, Colorado, but that is the excuse given for your insurance coverage being so much higher today than 3 years ago than if you lived in Denver. It seems to me it is a passive / aggressive strategy to get people to move to cities. Submit to the collective, resistance is futile.

I understand from news articles for our Socialist Republic of MD my coverage would be cheaper if I lived in Baltimore than out here in the supposed hinterlands of the state so far from civilization (a mere 10 minutes from I95 :roll: ). I mean medical coverage is so hard to come by out here where we have two full service hospital within 7 miles, three express care centers even closer than that, AI DuPont childrens medical center about 1/2 hour away along with all the Wilmington hospitals, CHOP along with all Phila hospitals less than an hour away and Hopkins and all the Balt hospitals less than an hour away.

I agree with Sam that some more light should be put on the insurance companies and their supposed non profit status and the salary structure of the legion of VP's & Presidents, board members, etc, etc. I am sure they aren't going to have a little thing like the ACA impact their salaries and yearly bonuses. Admittedly, my background in trying to work with them and providers at a prior job has me very biased against them. I sat in meetings and watched as HCFA was the puppet whose actions were controlled by the insurance industry reps sitting in the same meeting. No decision was done in the interest of improving the healthcare system, it was driven to not only do no harm to the payer's bottom line, but also to keep the providers under their collective thumb.

With the 75% increase over the past couple years our real out of pocket would be $14k and potential out of pocket could be $20k before insurance paid anything. hmmm i thought,....maybe it is time to 'self insure' our household. It is no coincidence that I owe $100 on my Federal tax return this year rather than being owed 1/2 of my first quarter estimated tax payment. ;)
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: Sunny Boy On: Tue Apr 01, 2014 12:14 pm

Costs by zip codes have been used by insurance companies for at least the 22 years I've lived here.

When I moved off Long Island to upstate NY, 22 years ago, I was due for a quarterly med insurance payment right after we moved. When the bill arrived, I saw that my insurance rates were cut almost exactly in half. We had to get new auto, and homeowner's insurance then and they were also about 50% of what we had been paying on LI.

I called the med insurance company figuring they goofed and I'd get a whooping big bill later on when they caught their mistake. The rep at the insurance company explained that the bills were automatically lowered by zip code when they got the change of address notice from the Post Office.

I asked why, because while things are less expensive upstate, the doc visits were not as much as 50% cheaper, and the autobody shops and parts suppliers were not 50% cheaper either.

The rep said that the rates were that much lower because, while yes the costs of business is less, the main difference was that there were far fewer lawyers upstate.

Paul
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: tjnamtiw On: Tue Apr 01, 2014 12:36 pm

It's called Capitalism, greed, but most importantly, please the shareholders at the expense of the customer. That certainly won't change under DemoCare. They've already proven that by raising rates to accommodate all the mandates that the Dem's have put on them to cover the uninsurable, provide contraceptives, etc, etc. People complained that the insurance companies were screwing people long before DemoCare came along and through rose colored glasses, believed the Dem's when they said that DemoCare would take the control out of the hands of the insurance companies, when, in fact, it has done absolutely nothing like that. IF you take the time to investigate, you'll see that each insurance company in each exchange still has the same wording to cover every possible contingency of medical need. The government has done nothing except made the rates go up and the benefits down. You personally are set with a nice cushy insurance plan so no worries for you.
It's really ashamed that you haven't taken the time to visit DemoCare and learn what it's all about and how your less fortunate Americans will be suffering.
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: rberq On: Tue Apr 01, 2014 1:07 pm

tjnamtiw wrote:You, like most, just don't get it!

Yes, I do get it. My comments were specifically on Jeff’s situation where he said he could insure himself, wife, and “all” his children (2? 4? 8?) for $140/month. The deductibles are a concern, but that is a pretty low premium for what I would call a “catastrophic” policy that could potentially pay hundreds of thousands of dollars benefits in a year. And the new policy can’t be dropped by the company now if Jeff has to file claims. You can bet his employer’s policy terminated if his employment terminated, which would be – when? – just at the point he got very sick and couldn’t work any longer!

People got used to health “insurance” paying for almost everything, which is really what ruined health insurance and fueled the fire of higher medical costs. Think about it: none of your other insurance policies work that way – your car insurance doesn’t pay for oil changes and your homeowner’s insurance doesn’t pay to repaint your house. Why should health insurance pay for routine stuff?
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: rberq On: Tue Apr 01, 2014 1:22 pm

titleist1 wrote:I agree with Sam that some more light should be put on the insurance companies and their supposed non profit status and the salary structure of the legion of VP's & Presidents, board members, etc, etc.

Yes, but a lot of that will take care of itself if more competition is “encouraged” among insurance companies. The really big place to look for savings is the substandard care and the predatory pricing policies of hospitals, which are now extending their tentacles into takeovers of many physician practices. I am now covered by Medicare, and one of the biggest satisfactions to me is that there is now a large organization (Medicare) to help keep the hospitals more reasonable on their charges. And yet even Medicare paid 30% more for my flu shot than if I had walked into a drug store and paid cash. I’m not sold on the idea that Medicare is under-paying anybody. I worked for a 300+ bed hospital for the last 23 years, and most of the requirements coming from Medicare were good for pushing the hospitals to provide proper care rather than just kill you with infections and unorganized haphazard treatment. And still there is a lot of room for improvement.
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: Sunny Boy On: Tue Apr 01, 2014 2:28 pm

Enjoy it while your healthy.
Because in the meantime Medicaid, the other Gov. insurance, has been cutting back payments to nursing homes and as a result, slowly putting them out of business, . . unless like some, they can also start doing short-term rehab in house, which pays much better.

My girl friend got her present job because she not only ran a long term unit for many years, she also ran a rehab section for a 350 bed home that also had to put in a large rehab unit to stay alive. And, some of the long term care facilities are dropping long term care and replacing it with better paying short term care, and/or assisted living. Between that and closings, the shortage of long term care beds is getting worse, just as the first baby boomers are getting close to the age of needing it.

Paul
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: samhill On: Tue Apr 01, 2014 2:33 pm

The highest price hikes in both hospital & ins. started when the treatment of the uninsured had to be taken care of by hospitals, so as people started using the ER (most expensive) as a family doctor & couldn't be turned away the hospitals couldn't absorb all the costa so they started raising prices which in turn increased ins. costs. That's why (besides the greed factor) health care went up as fast as it did, somebody has to pay for that free ER treatment so guess who. The greed set in when they found they could get away with it. Health Ins. has been going up rapidly for decades, remember both sides promised some type of H.C. price relief, the medical & insurance lobbies paid off all the house members to be taken care of.
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: rberq On: Tue Apr 01, 2014 3:32 pm

Sunny Boy wrote:Medicaid, the other Gov. insurance, has been cutting back payments to nursing homes and as a result, slowly putting them out of business
Nursing home care, and who will and should pay for it, are subjects in and of themselves, not directly related to an Obamacare discussion. Probably deserves its own separate thread, as it will affect a lot of us baby boomers, alas ....
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: rberq On: Tue Apr 01, 2014 3:37 pm

"WASHINGTON (The Borowitz Report)—Accusing them of involvement in “a widespread conspiracy to save President Obama’s failed health-care program,” Rep. Darrell Issa (R-California) today subpoenaed the approximately seven million Americans who have signed up for Obamacare so far."

http://www.newyorker.com/online/blogs/b ... 20%2854%29
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: Sunny Boy On: Tue Apr 01, 2014 4:36 pm

rberq wrote:
Sunny Boy wrote:Medicaid, the other Gov. insurance, has been cutting back payments to nursing homes and as a result, slowly putting them out of business
Nursing home care, and who will and should pay for it, are subjects in and of themselves, not directly related to an Obamacare discussion. Probably deserves its own separate thread, as it will affect a lot of us baby boomers, alas ....


Maybe, maybe not.

You brought Medicare into it. I mentioned Medicaid. Obummercare, Medicare, and Medicaid are all run by the same people - Health and Human Services. With the stroke of a pen your being happy with your Medicare can change over night, . . just like what happened to Medicaid. Only difference is the Medicare folks are more of a better group to target for getting votes for Dems than the old folks in nursing homes (unless they die in Chicago).

But, they are all related. And you may want to watch what is happening to Medicaid to see what may be coming next for Medicare - if you care. ;)

Paul
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: ONEDOLLAR On: Tue Apr 01, 2014 4:53 pm

rberq wrote:"WASHINGTON (The Borowitz Report)—Accusing them of involvement in “a widespread conspiracy to save President Obama’s failed health-care program,” Rep. Darrell Issa (R-California) today subpoenaed the approximately seven million Americans who have signed up for Obamacare so far."

http://www.newyorker.com/online/blogs/b ... 20%2854%29


Satire at its finest..... :lol:
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: Billyirons On: Tue Apr 01, 2014 5:53 pm

My Obamacare (very long)Saga
I closed my construction business because of the economic downturn. I was 57 years old. (Don't feel bad for me- I am not rich but I ain't poor!) Since I had only a very low investment income, I purchased only a hospitalization health plan. No doctors, drugs or outpatient services. (I do not use them ). My plan cost $149.00/mo. I figured I would be covered for catastrophic problems and pay (if I had to) for everything else until I started getting Medicare at 65.
My insurance company notified me in September that my policy would end December 31st because of the ACA. I then made multiple tries to sign up on the Federal website, then the NYS exchange. After much frustration, I found that, because of my low income, I could only get Medicaid and Was Not Allowed To Buy Insurance. Medicaid is not good for me because I have assets. Except for my house (which is in a medicaid trust), the Gov't could (would), ultimately, go after everything else for all services rendered under Medicaid!
I could only buy insurance on the open market, but get no tax credits to help costs.
I realized that by taking my Social Security early, at 62 (NOT my original plan), I could raise my income high enough to buy insurance on the exchange! My (poor & only) choices were 6 Silver Plans from only 2 insurance companies. The plans were virtually the same and I could NOT find out which hospitals, doctors or providers were included in the plans because "The Provider List Had Not Been Populated". They all had various co-pays and all had a 'maximum out-of pocket' cost, to me, of $4000.00. The policy cost is $481.93 /mo Minus my subsidy $237.00 /mo which leaves $244.93 /mo that I have to pay.
I actually purchased my new ACA Plan twice because the purchase 'disappeared' the first time! The second time (after signing up on the NYS Exchange) I made some phone calls and finally was connected to a insurance company ACA representative who billed me online and let me pay online. I paid online while on the phone with him, December 23.
YAY!! I had insurance for January 1, 2014!!
Obama said that the Gov't would allow the insurance companies to continue old plans (like the one I had). There was not enough time and I could not take the chance of being uninsured! There is an astronomical difference in the price for services that insurance companies pay and the cash price that I would pay ! But I was relieved that I now have insurance!
Before the ACA, I had the (limited) medical insurance that I wanted (with no co-pays). Because of the ACA, I was forced to waste my time, been frustrated, worried, and finally, been 'rewarded' with a policy that I was 'forced' to buy, did not want, and that may cost me up to $6939.16 per year! I also was 'forced' to begin taking my SS early and at a lower rate!
I believe in self determination, freedom, and limited government. Repeal the Affordable Care Act!
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: rberq On: Tue Apr 01, 2014 6:25 pm

Billyirons wrote:My Obamacare (very long)Saga

So to summarize, you are paying $95 more per month than you previously were paying. And your new insurance has a maximum out-of-pocket of $4000 per year. You don't really say what your previous insurance covered, except that it was a hospitalization plan. Did it cover the full daily room charge, or just a limited dollar amount per day? Did it pay a piddly little flat rate per day, or did it cover all drugs, xrays, MRIs, CAT scans, lab tests, physician visits, ancillary treatments, surgeon's fees, operating room charges, ICU, etc. etc. etc. while you were in the hospital? Did it limit the number of days it would pay? Did it have an annual or monthly or lifetime benefit limit? Was it renewed annually or monthly, and could the company refuse to renew at their discretion and thereby wiggle out of further payments? You say you don't use doctors, but you would have to use one to get admitted to the hospital. How about followup treatment after discharge from the hospital? Again, we would need to see exactly the coverage provided by your old insurance, but I bet it would have left you with out-of-pocket costs FAR more than $4000 for any serious illness or injury. How did you project to pay those costs?
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: Billyirons On: Tue Apr 01, 2014 6:51 pm

rberg
It does not matter what my old insurance covered because I was happy with it. But in a nutshell, it covered all tests doctors, surgeries etc IN the hospital including ER (If I was admitted, if Not I paid for ER). I never saw a policy without a lifetime limit. I knew that before I signed up. Nothing outside the hospital was covered (and I know that those costs can be insanely expensive. The policy renewed once a year.
I was willing to take the risk on any other care I needed- I wrote that I am not poor.
The most important point is my insurance is my choice!
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Re: Local news on Obamacare from the CEO of the Cleveland Clinic

PostBy: scalabro On: Tue Apr 01, 2014 6:53 pm

Boy am I glad I work on an EVIL (sarcasm) health care company's jet.

This year they gave us the option to go off the "company" plan and onto obamacare.

Maybe next year it will be mandatory.

I wonder what will happen to the Democratic Party when the employer mandate kicks in?
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