4 ms·

Yes. I have actually bought my own insurance through one of the state-run exchanges in the past.

ddingus 7y ago
For anyone with complications, medical history that is non trivial, networks become very important, and do costs. Networks take people in and out of the chain of care providers, and costs swing dramatically. The whole affair adds zero value when compared to simpler Medicare For All type plans. People in my life got sick, and the financial carnage has gone on for decades. This pretty much rules out any favorable view on markets and private insurers I may have. And I am by no means a unique, or even uncommon case. If it were not for family, I would have picked up and left this cruel system a decade ago.
- tptacek 7y ago
  Networks are very important with all kinds of insurance. The thing you notice when you switch from employer-covered insurance to ACA market insurance is all the fiddly choices your employer was making for you. You can say that having to make these choices is a process failure of the ACA, or you can say that having the freedom to make those choices yourself is a benefit of the ACA. I'm not sure what M4A has to do with this, and, in particular, to relate this story back to the thread, you should be aware that Medicare drug benefit administration is also privatized, and that somewhere between 1/3 to 1/2 of Medicare recipients also get Medicare Advantage, a private insurance rider to Medicare that is largely defined by network restrictions.
  - ddingus 7y ago
    M4A has everything to do with this. Millions of Americans have and are being harmed financially and or physically by this patchwork mess. The other thing you notice is insurers treat people who they know will cost them much differently. M4A will centralize most of this and will distribute cost and risk as widely as possible
    - tptacek 7y ago
      Could you formulate a response like this that addresses the point I just made, which is that Medicare also includes, for a huge chunk of its recipients, network restrictions, and for all its prescription drug recipients private insurance?
      - ddingus 7y ago
        For now it does. That will not always be the case, or should it be, the regulatory picture will appear very different than it does today. Those things simply do not add value. They do help to make more money. When health care is about making money, it is not about making people healthy. And it is not about cost either. Very large numbers of Americans are both impacted in a negative way, and long past the idea of private insurers being good primary care vehicles. They aren't. Private insurers should be forced out of primary care. If I had my way, doing that would be illegal. There is a basic conflict of interest between an insurer making money and what is best for sick people. I will tell you personally, the hell I have gone through, family members dead, others living with pain, financial damage, homes lost, I am very highly motivated to do all I can to see an end to our current, increasingly cruel and ineffective system. Talk about death panels. Yeah, happened to us. Unnecessary that it did too.
        tptacek 7y ago
        So really your argument has nothing to do with Medicare? You're just using the term "Medicare" as a placeholder for whatever health policy you come up with? I'm not trying to be snarky: this is also what several of the Democratic frontrunners are doing.
        ddingus 7y ago
        Your words not mine. The original intent of Medicare is intact in the proposals a growing number of people are moving to actualize. I am not coming up with "any policy" I am contributing to the Medicare For All effort. Does that clear things up?
        7y ago

For anyone with complications, medical history that is non trivial, networks become very important, and do costs. Networks take people in and out of the chain of care providers, and costs swing dramatically. The whole affair adds zero value when compared to simpler Medicare For All type plans. People in my life got sick, and the financial carnage has gone on for decades. This pretty much rules out any favorable view on markets and private insurers I may have. And I am by no means a unique, or even uncommon case. If it were not for family, I would have picked up and left this cruel system a decade ago.

tptacek 7y ago
Networks are very important with all kinds of insurance. The thing you notice when you switch from employer-covered insurance to ACA market insurance is all the fiddly choices your employer was making for you. You can say that having to make these choices is a process failure of the ACA, or you can say that having the freedom to make those choices yourself is a benefit of the ACA. I'm not sure what M4A has to do with this, and, in particular, to relate this story back to the thread, you should be aware that Medicare drug benefit administration is also privatized, and that somewhere between 1/3 to 1/2 of Medicare recipients also get Medicare Advantage, a private insurance rider to Medicare that is largely defined by network restrictions.
- ddingus 7y ago
  M4A has everything to do with this. Millions of Americans have and are being harmed financially and or physically by this patchwork mess. The other thing you notice is insurers treat people who they know will cost them much differently. M4A will centralize most of this and will distribute cost and risk as widely as possible
  - tptacek 7y ago
    Could you formulate a response like this that addresses the point I just made, which is that Medicare also includes, for a huge chunk of its recipients, network restrictions, and for all its prescription drug recipients private insurance?
    - ddingus 7y ago
      For now it does. That will not always be the case, or should it be, the regulatory picture will appear very different than it does today. Those things simply do not add value. They do help to make more money. When health care is about making money, it is not about making people healthy. And it is not about cost either. Very large numbers of Americans are both impacted in a negative way, and long past the idea of private insurers being good primary care vehicles. They aren't. Private insurers should be forced out of primary care. If I had my way, doing that would be illegal. There is a basic conflict of interest between an insurer making money and what is best for sick people. I will tell you personally, the hell I have gone through, family members dead, others living with pain, financial damage, homes lost, I am very highly motivated to do all I can to see an end to our current, increasingly cruel and ineffective system. Talk about death panels. Yeah, happened to us. Unnecessary that it did too.
      - tptacek 7y ago
        So really your argument has nothing to do with Medicare? You're just using the term "Medicare" as a placeholder for whatever health policy you come up with? I'm not trying to be snarky: this is also what several of the Democratic frontrunners are doing.
        ddingus 7y ago
        Your words not mine. The original intent of Medicare is intact in the proposals a growing number of people are moving to actualize. I am not coming up with "any policy" I am contributing to the Medicare For All effort. Does that clear things up?
        7y ago