4 ms·

For a family of 4, I pay total of about 20K per year as well (employer + employee cost) and even after that, we have a $5000 deductible AND on top, we have to b

For a family of 4, I pay total of about 20K per year as well (employer + employee cost) and even after that, we have a $5000 deductible AND on top, we have to be concerned about in-network/out of network bullshit. So for me, unless $25,000 has been spent, insurance company would not even come in the picture AND I am always scared if I wil get a bill that was out of network. This madness has to end and I don't give a shit that we are trying Single Payer. Everyone talks about Cost but what about Administrative issues ? Fighting incorrect claims, billing errors and what not. As far as I am concerned, this is one area where I am totally against Profit making motive. Let me correct myself. I am totally ok with Doctors and Hospitals directly making some profit but not insurance companies. Private insurance companies can go suck it. I am sick and tired of paying for their profits. Status quo has to change, that's it. EDIT: I am not against Insurance of some sort but they should only exist for Catastrophic illnesses. I need to go see my doctor for preventive care ? No need to involve Insurance company and wasting time on filing a claim that by definition requires more money to pay for the people involved unnecessarily.

A4ET8a8uTh0 7y ago
Holy crap. I am in the process of "fighting" with insurance over meds we paid out of pocket even though they were supposed to cover it.. long story. We thought we hit a wall and we contacted one of the enforcement agencies. All of a sudden, we get an individual refund form and a place to mail it to. The amount was not astronomical ($1.5k), but not something I can just ignore. And that happens all over the country. Not everyone has my time to call, write and complain. Those are the moments I am ready to change the system. It is not really working for me. It is merely acceptable to a few.
- codegeek 7y ago
  yep. Dont even get me started on how many times I had to fight with the insurance/billing/admin departments to even understand why I received a bill and for what. They must have a team of smart cryptographers to generate those crazy bills and invoices /s
  - jrs235 7y ago
    And after you think you have it all figured and and properly paid, a new bill appears out of the blue 6 months after your visit.
    - codegeek 7y ago
      Bingo.
- TuringNYC 7y ago
  My friends hired a consultant to reconcile pregnancy related bills coming from all angles from a half dozen entities. The consultant corrected things from over $17,000 to “only” four figures of copays and balance billing. That is nuts. The fact that a consultant with expertise in this “skill” exists and is required is also a sign of a supremely broken system.
meheleventyone 7y ago
The seemingly (to me) crazy thing is that private insurance in places with single payer healthcare aren’t like this at all. Our entire insurance bill for everything from healthcare to house insurance for a family of four is less than a quarter of that. There’s even pretty affordable private GP clinics where I’d never even think about using my insurance. It’s reasonably common to have private healthcare insurance for unexpected events even in places with national health services. I’ve had it variously through work, unions and now as a private individual. Typically you want it to make up the difference between the level of provided state support and what you’d lose by not working. Personally I’d rather than private insurance and healthcare industry wasn’t necessary but the American debate seems polarised into either/or rather than realising that it’s very common for private healthcare to coexist and be part of nationalised healthcare systems.
- gremlinsinc 7y ago
  Part of the administrative savings though is the fact that $0 dollars is spent to essentially what amounts to 'billing' agencies. Every $ spent on medical billers in hospitals, lawyers contesting claims, etc... can better be spent inside hospitals and research labs, etc.. John Oliver said basically our plan does go above and beyond all other plans, covers more, etc... so it's basically the utopia of plans. Of course it's probably better to start at utopia and get semi-utopia than start at the public option and only get the public option. I can see maybe something bigger to cover things like maybe subsidies for fertility which my wife's really concerned about - because there's a LOT of emotional depression related to that, and maybe even adoption which sort of ties into fertility. Though, I'd definitely be happy w/ lesser I mean what we have now is murderous.
usaar333 7y ago
Are admin issues guaranteed to be better under a single payer system? Don't people run into all sorts of problems with Medicare - what it will pay vs. what it won't? I give you though that at least it is one set of admin rules than N.. which might be better.
- codegeek 7y ago
  definitely not guaranteed. But I am so sick of status quo that I am willing to try ANYTHINg different. It just happens to be Single payer option at the moment.
- markroseman 7y ago
  Depends how it's organized, but it could be much better. In Canada, physicians don't need to get approval before they do everything, admin overhead for a physician to bill is a matter of a few minutes a week. Not two full-time staff members just for that.
Balgair 7y ago
I'll chime in with my anecdata on US health insurance: My SO has a condition that requires a pill to help out with. My SO has some trouble working regular hours due to this condition and takes one pill per day. Depending on the insurance, we have paid between $1 and $5 per pill in the past. This particular chemical is a part of horse feed. Like, how we just put Vitamin D in Milk, or Iodine in Salt; they put this chemical in horse feed. It does not change the cost of the horse feed appreciably, just like with human additives. I was once offered a job. When we dug into the insurance that the job had, it would have cost us ~$100 per pill, or ~$3k/mo. It was an otherwise dream job, perfect for me. But a ~$36k/year increase in our yearly cost of living. We had to turn the job down, of course. For a substance that they put in horse feed for basically free. The last time that I posted this issue on HN, a VERY kind person pointed me to a way to buy this chemical online and in bulk. It comes to your door in volumes of about ~$100 per CUBIC METER. They ship by volume, not weight. US Healthcare is totally, completely, utterly, broken.
- xtreme 7y ago
  Wow. At that point it makes more sense to fly out to another country, see a doctor there, pay for the medication in cash, and take a vacation at the same time with money left over.
  - Balgair 7y ago
    Some already are: https://www.youtube.com/watch?v=7Z2XRg3dy9k https://www.youtube.com/watch?v=7Z2XRg3dy9k ~ the 7 minute mark

A4ET8a8uTh0 7y ago

Holy crap. I am in the process of "fighting" with insurance over meds we paid out of pocket even though they were supposed to cover it.. long story. We thought we hit a wall and we contacted one of the enforcement agencies. All of a sudden, we get an individual refund form and a place to mail it to. The amount was not astronomical ($1.5k), but not something I can just ignore. And that happens all over the country. Not everyone has my time to call, write and complain. Those are the moments I am ready to change the system. It is not really working for me. It is merely acceptable to a few.

codegeek 7y ago
yep. Dont even get me started on how many times I had to fight with the insurance/billing/admin departments to even understand why I received a bill and for what. They must have a team of smart cryptographers to generate those crazy bills and invoices /s
- jrs235 7y ago
  And after you think you have it all figured and and properly paid, a new bill appears out of the blue 6 months after your visit.
  - codegeek 7y ago
    Bingo.
TuringNYC 7y ago
My friends hired a consultant to reconcile pregnancy related bills coming from all angles from a half dozen entities. The consultant corrected things from over $17,000 to “only” four figures of copays and balance billing. That is nuts. The fact that a consultant with expertise in this “skill” exists and is required is also a sign of a supremely broken system.

meheleventyone 7y ago

The seemingly (to me) crazy thing is that private insurance in places with single payer healthcare aren’t like this at all. Our entire insurance bill for everything from healthcare to house insurance for a family of four is less than a quarter of that. There’s even pretty affordable private GP clinics where I’d never even think about using my insurance. It’s reasonably common to have private healthcare insurance for unexpected events even in places with national health services. I’ve had it variously through work, unions and now as a private individual. Typically you want it to make up the difference between the level of provided state support and what you’d lose by not working. Personally I’d rather than private insurance and healthcare industry wasn’t necessary but the American debate seems polarised into either/or rather than realising that it’s very common for private healthcare to coexist and be part of nationalised healthcare systems.

gremlinsinc 7y ago
Part of the administrative savings though is the fact that $0 dollars is spent to essentially what amounts to 'billing' agencies. Every $ spent on medical billers in hospitals, lawyers contesting claims, etc... can better be spent inside hospitals and research labs, etc.. John Oliver said basically our plan does go above and beyond all other plans, covers more, etc... so it's basically the utopia of plans. Of course it's probably better to start at utopia and get semi-utopia than start at the public option and only get the public option. I can see maybe something bigger to cover things like maybe subsidies for fertility which my wife's really concerned about - because there's a LOT of emotional depression related to that, and maybe even adoption which sort of ties into fertility. Though, I'd definitely be happy w/ lesser I mean what we have now is murderous.

usaar333 7y ago

Are admin issues guaranteed to be better under a single payer system? Don't people run into all sorts of problems with Medicare - what it will pay vs. what it won't? I give you though that at least it is one set of admin rules than N.. which might be better.

codegeek 7y ago
definitely not guaranteed. But I am so sick of status quo that I am willing to try ANYTHINg different. It just happens to be Single payer option at the moment.
markroseman 7y ago
Depends how it's organized, but it could be much better. In Canada, physicians don't need to get approval before they do everything, admin overhead for a physician to bill is a matter of a few minutes a week. Not two full-time staff members just for that.

Balgair 7y ago

I'll chime in with my anecdata on US health insurance: My SO has a condition that requires a pill to help out with. My SO has some trouble working regular hours due to this condition and takes one pill per day. Depending on the insurance, we have paid between $1 and $5 per pill in the past. This particular chemical is a part of horse feed. Like, how we just put Vitamin D in Milk, or Iodine in Salt; they put this chemical in horse feed. It does not change the cost of the horse feed appreciably, just like with human additives. I was once offered a job. When we dug into the insurance that the job had, it would have cost us ~$100 per pill, or ~$3k/mo. It was an otherwise dream job, perfect for me. But a ~$36k/year increase in our yearly cost of living. We had to turn the job down, of course. For a substance that they put in horse feed for basically free. The last time that I posted this issue on HN, a VERY kind person pointed me to a way to buy this chemical online and in bulk. It comes to your door in volumes of about ~$100 per CUBIC METER. They ship by volume, not weight. US Healthcare is totally, completely, utterly, broken.

xtreme 7y ago
Wow. At that point it makes more sense to fly out to another country, see a doctor there, pay for the medication in cash, and take a vacation at the same time with money left over.
- Balgair 7y ago
  Some already are: https://www.youtube.com/watch?v=7Z2XRg3dy9k https://www.youtube.com/watch?v=7Z2XRg3dy9k ~ the 7 minute mark