Weekend Open Thread   16 comments

Sorry for the delay this week, but here is the usual weekend open thread, where you folks can discuss any topic you like.

For your consideration, I offer…radio shows.

For the oldest among you, you may remember old time radio shows. When I was a kid, I remember listening to CBS Radio Mystery Theater, one of the last of the radio shows. Now, thanks to the internet, there is a website which features all of the episodes from CBS Radio Mystery Theater. I recommend it. (link here)

The reason I bring this up is because my daughter introduced me to a new website: Night Vale. It serves up episodes (or in “internet-ese”, podcasts or webisodes) of the story of a rather strange town, told by a “newscaster”/narrator. I can’t decide whether the show is funny or creepy, or a little of both. Either way, it certainly isn’t dull.

But it is nice to see a modern take on the old radio shows. Who would have thought the internet would bring back the spoken word as a medium of storytelling?

Enjoy your weekend folks! Or as E.G. Marshall used to say at the end of CBS Radio Mystery Theater, with the sound of a creaky door closing in the background, “Pleasant…dreams?”

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Posted September 27, 2013 by edmcgon in Open Thread

16 responses to “Weekend Open Thread

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  1. Obamacare exchanges open Tuesday – anybody planning to enroll? Do you find it inexpensive? affordable? . Costs will be different by geographical location and insurer. Some insurers did not even join because they do not find it profitable. e.g. Aetna not in NY. All the talk about low premiums – but can hardly find information on deductibles and out-of-pocket expenses; NY plans just came out – http://healthbenefitexchange.ny.gov/sites/default/files/Standard%20Products.pdf
    Bronze plan in NY are ‘cheap’ until you pay 50% co-insurance after a $3000 deductible and out-of-pocket limit is of $6350. Silver is not much better with co-payments of 30% or more after a deductible of $2000 and out-of-pocket limit of $5500.
    Does this sound affordable?

    • I have health insurance through my work. I’m already scared to imagine how much it will cost me next year. 😛

    • I currently pay for something that would be considered in the “bronze” level, but I’m already with one of the most affordable insurance carriers there is.
      It is Kaiser Permanente, and they are a non profit organization so you aren’t going to find a cheaper deal out there from what I can see.

      They have already “adjusted” my costs up by a little bit (and the coverage for things I don’t need like pregnancy coverage), they change their rates in August and it didn’t go up too much this year, but I’m guessing next year will be the one that really tells the story. The year they required them to charge the same for women as men (even though women typically need two doctors and men one) my coverage went up by a few dollars a month and my wife’s went down by the same amount. So for us that was a wash.

      Anyways I have tried to get numbers and found it really hard (no hard numbers as of now), but as close as I can tell, using Kaiser Permanente as a guide since they are going to have plans for both private and the exchanges, and they have no motivation be unfair about it, it is really going to come down to the tax credits (and how much you will get based on how much you make).

      In other words if people think that the exchanges will bring the prices from single payer amounts down to “group” amounts, I don’t see that, at least not with Kaiser Permanente (which might already be giving “group” rates to individuals I guess).

      But then again I don’t think people with insurance through their jobs have any clue at the price of these “group rates” are. It is all hidden and companies don’t even want to tell you how much they pay even if you ask. They all gripe about how much they pay, but that is usually a tiny part of the real cost.

    • More affordable than not having insurance. If you need those same services without insurance you pay 100% of the rack rate charge (normally insurance allowed amount is 30-40% of the quoted price) and there is no out of pocket maximum.
      I have an individual plan ($1800 a month) due to a pre-existing condition but I am not big on getting authorization or referrals so will be looking at my options after the budget and debt ceiling battles are done. I have no desire to change policies, have the Repubs gut/kill ACA and then have my new insurer drop my policy.

      Robb

  2. This is one thing I can’t complain about at my current job. I am making less than I was before being laid off 3 years ago but I pay nothing for my health coverage, no co-pay and $1500 deductable. Came in handy when I had bi-lateral hernia surgery a month ago. My bill for office visits and surgery was $13,500 but I paid the $1500 and that is it.

  3. In the low premium NY Bronze plan, this medical expense would cost $3000 up front to get to the deductible; then plan will only pay 50%; patient pays 50% co-insurance. Gold or platinum plans have lower deductibles and co-insurance but much higher premiums that are not affordable by unemployed/underemployed. Which means those who have bronze plans and cannot afford the deductible and co-insurance may poo-poo pains that could turn out to be symptoms of some serious condition. In this sense, the bronze plan is basically a catastrophic plan which will be available only for under 30 years old.

    Some articles a while back cited statistics that showed actual costs for medical services have gone down – do you think something to do with some people, elderly especially, who said – “no need to visit the doctor or go to ER – it’s nothing – will feel better in the morning.”

    By the way, for 2013 medical deduction kicks in only after 10% of AGI; so in essence increasing taxes for some to help fund the tax subsidies for some – rob Peter to pay Paul.

  4. Keep in mind that the coinsurance reflects the adjusted rate you’re getting because you have an insurance plan. An example: Routine blood work I just did would have cost over $1200 if I did not have insurance. Because I do, the “adjusted” rate the insurance negotiated with the lab results in a cost of about $200. With a 50% coinsurance, I pay $100 as does my insurer. So the 50% coinsurance results in much higher savings over what you would have gotten solo/uninsured. This is true for procedures, office visits, hospital stays – anytime you belong to an insurance plan where your insurance negotiates rates. I keep a high deductible because for me, with no major health issues, the greatest savings in having insurance is the adjusted rates it has negotiated with providers.

    • QD,
      Could you have gotten the bloodwork done for less if you had negotiated cash up front for payment? Many doctors, hospitals, and even labs will accept less so they don’t have to deal with insurance.

      • I have some relatives that negotiated quite a bit of a discount by paying cash for procedures at the hospital (insurance wasn’t a possibility for them since they are not US citizens).

  5. I can’t wait to see what happens at work next week. HR is having some big meeting in the morning to tell up about our plan chores. We use Blue Cross which is non profit. I’d love for them to offer a plan to cover our 10,000 out of pocket.

    Obama care does cover preventative care at 100% correct??

    • The requirement for preventive care to be cover 100% for all insurance plans has been in place for more then a year.
      Of course what “preventive care” covers isn’t that much really.

      BTW we carry insurance for “catastrophe only”/preventive purposes, and me and my wife are not under 30. We are 56.
      We are both in good health.

      Let me runs some numbers by you. Each of us pays $223 a month. If I was to buy the same plan that the company I use to work for bought, it would be pushing $800 a month (co pay $20). Kaiser is a full medical system and an insurance side (which treats the medical side as a completely different company). So it is interesting to see that it when the medical side says the bill is $X and the insurance side says that we get a reduction of the price.

      Anyways the key factor is that even though other then annual doctor visits, some x-rays, flu vaccinations, we pay for everything, and frankly I don’t even think about “50%” or whatever, it is just the “what it costs” to me. The rest is funny money that companies do between departments and such. Different care is different costs. The key factor to me is the maximum $6000 max out of pocket a year per person (There is a $3000 deductible, but frankly that just means up to that point you pay “full” and after you pay “reduced”). So that limits the risk. We also plan some for the occasional getting sick and such. If you figure one person hits the max, well the difference between $800 and $223 is already more then what the max is. When you add in the years you don’t pay anywhere near that and then you have two people (and only one hits the max), and then add the fact that all the premiums and any other fees go towards the 7.5% AGI you have to get over (as in you might get a deduction, which is very possible when you are living on retirement like “income”).

      The “catastrophe only” plans do make sense for basically any healthy single/couple (for families that is a different story).

      • Corrections. I rechecked and my plan is $5000 deductible and $7500 max. Also the “full” plan ($25 co-pay) is $635 a month (I guess I remembered it wrong). So in a “max” year on my plan it would be (“full” plan”) $635/per month + co-pays = $7620 + co-pays vs $7500 + $2676 premiums. So certainly for healthy people (especially a couple) the “pays all, $635 a month” plan costs more for most people.

        How this is all going to shake out with the exchanges, I have no idea. It is a wait and see thing I guess.

  6. BTW an interesting fact. Every year the price goes up by a small amount because age, but the year that we are eligible for medicare the price goes up drastically. Now why would you think that would be true? Simple it is the “entitlement” factor. As in it is that year that the government/taxes start paying them, so the out of pocket doesn’t change much for the person, so they don’t gripe about it.

    Of course I don’t really blame Kaiser in this (or think they are doing anything wrong per se), it is just like any other business, someone has to pay, but sometimes the costs get spread out in ways that are not directly related to the costs per person.

  7. Friend, full time employee, has employer health plan, with $40.00 co-pay after a deductible of $1750. Doctor billed insurance for $260; insurance contracted member rate is $123.02. Insurance did not pay anything because the $1750 deductible has not been met yet. Most, if not all, insurance plans pay only after deductible is met. After the deductible is met, she would only pay a $40.00.

    In a non-employer, NY ACA bronze plan, patient will have to first spend $3000 (deductible) before the 50/50 insurance cost-sharing kicks in. For a reasonably healthy person, the insurer most likely will not have to pay anything.

    Preventive care listed at https://www.healthcare.gov/what-are-my-preventive-care-benefits/

    • Well they would have to pay for the preventive care, but that is it. Yes for a “deductible” plan the insurance companies skate for healthy people. It is those people that pay for the unhealthy ones (and for the insurance company profit).

      The “full plans” I was talking about though are not “deductible” plans. They are co pay only. As in you pay $25 a visit and that is it (other then the premiums).

      When you start to talk about deductible plans (which all the plans in the exchanges are) the real modification for having it, is the same reason for having fire insurance on your house, “just in case”.

  8. Chris,
    ” When you start to talk about deductible plans (which all the plans in the exchanges are) the real modification for having it, is the same reason for having fire insurance on your house, “just in case”. Same for car insurance.
    This is true for the healthy and the non-Medicare folks. For Medicare, it is always a 20/80 cost share, and no out-of-pocket limit. Medigap plans cover the 20% for high premiums -not affordable by many; ergo, many seniors who are lucky enough to hang on to their jobs until age =/+70 will work for the employer health plan.

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