Problem with health care costs in US

[jenbaby75 283]

Obamacare is killing the little guys. It may give people mediocre care, but it's destroying the mom & pop pharmacies, that treat their patients like real people, rather than a number.

[no onions 258]

I feel like people have opinions on this topic (Obamacare) that are not supported by facts.

I cannot find any rational (legit) source that indicates mom & pop pharmacies are being destroyed (by Obamacare).

Now -- I did find an older article that said the Express Scripts-Medco merger could have a negative effect on independents.

Edited January 25, 2015 by no onions

[jenbaby75 283]

Thanks, that wasn't opinion, it's a fact. I personally know of a well respected pharm that was closed due largely in part to the effects of Obamacare, but good for you for defending it. I am not one to spew unsupported opinions. I also know several people who have to use Obamacare due to employers not offering insurance, and ALL of them (even the obama supporters) say it is crap insurance. Maybe it needs time to Iron out the defects. Personally, I wouldn't purchase it, defects or no defects. I am blessed with amazing insurance. Healthcare cost is ridiculous in and of itself.

[Kindle 8,667]

Well here's my experience with Obamacare.... I am self employed and have carried an individual health insurance policy for the past 15 years. In 2013 (the last year before Obamacare) I paid $256/month for a policy with $30 office visits and a $2000 deductible with 80/20 coverage after that up to a $5000 max OOP. It was through Blueshield and they were very good about approving and paying for everything. Even had a cervical spine fusion surgery 6 years ago with no financial issues...had an MRI, X-rays, referral to a specialist, surgery itself, PT and followup visits....i just paid my deductible.

Then along came Obamacare. I now pay $316/month for a policy with NO office visit copays and a $5000 deductible. Basically i have to fork out $8692 in any given year before they pay a penny. Still through Blushield, but now have to fight to get anything approved. I'm having neck issues again and have complete numbness in both arms and they will not approve an MRI or CT. I had C. diff last year and they wouldn't pay for the curative fecal transplant, despite 2 appeals from my gastroenterologist. After 2 months of trying to cure it "their way" by taking antibiotics that made me sick and having to get IV fluids for dehydration 3 times, I finally just paid for the fecal transplant myself. Took about 30 minutes, worked like a charm and prevented months of suffering, permanent damage to my colon and probably being admitted to the hospital. And the b***h of it is, since it wasn't approved, the $3000+ I paid didn't even go towards my deductible.

I am good friends with my PCP and his wife, who is the office manager of his clinic. She said dealing with insurance has become a nightmare since the switch. They don't accept any new Medicare or Obamacare policies, but are stuck with all the "grandfathered" patients (like me). So comparing apples to apples, in my case, Obamacare is rotten.

Edited January 25, 2015 by Kindle

[Debbie Jean 406]

Thanks, that wasn't opinion, it's a fact. I personally know of a well respected pharm that was closed due largely in part to the effects of Obamacare, but good for you for defending it. I am not one to spew unsupported opinions. I also know several people who have to use Obamacare due to employers not offering insurance, and ALL of them (even the obama supporters) say it is crap insurance. Maybe it needs time to Iron out the defects. Personally, I wouldn't purchase it, defects or no defects. I am blessed with amazing insurance. Healthcare cost is ridiculous in and of itself.

So Jenbaby75 knows people and that translates to "fact"? Thank goodness you're not one of my students. Please provide an objective citation from a credible source to support your position. Until you do it's an opinion. The dictionary is your friend. Check it.

If you want opinions I'll give you mine. National chains are killing local pharmacies. Stop going to CVS Walgreens Rite Aid or whatever there is in your neck of the woods. BTW its a variation of the Malls are killing Main St problem. If you want small businesses to flourish stop going to the malls and large chains. Patronize them. Get everyone you know to patronize them.

Good for you having nice insurance. I'm old and am grandfathered in to a "Cadillac" policy. I pay $250 deductible per year. Thats it. Nothing more. I know people who before the ACA had nothing. This has been such a blessing for these people. None of them is getting my kind of insurance. But they can see a doctor when they are sick and not wind up in the ER with pneumonia followed by a 2 week hospitalization which I will pay for in my billing fees etc.

As people who actually work in the medical business have said no one with insurance pays those usurious prices as billed. The hospital billed my insurance $36,000+ and settled for $6500. I expect something similar when the other bills come in, surgeon, anesthesiologist etc. Read your EOB.

What ticks me off is that if the above is considered a fair reimbursement, the people who self pay should be getting this discounted rate as well at the same Center of Excellence hospital I did outside NYC. Reading this forum however tells me that is not the case.

Edited January 25, 2015 by Debbie Jean

[Inner Surfer Girl 12,015]

Time magazine had an entire issue dedicated to looking at what is wrong with the US medical system in 2013. The article is called Bitter Pill. I believe you can read it behind a paywall on their website. It is also included in the anthology Best American Magazine Writing 2014 (which is where I just read it). I would consider it a must read for anyone in the US.

I am definitely on the side of single payer and think that Obamacare is a step in the right direction but doesn't go nearly far enough because of the "health industrial complex" lobbying/power.

Edited to add: http://time.com/198/bitter-pill-why-medical-bills-are-killing-us/

Edited January 25, 2015 by Inner Surfer Girl

[jenbaby75 283]

This is obviously very important to you. If I felt it necessary to cite specific details, or if I was writing an essay, I would contact the physicians, patients, pharmacists, small business owners, etc, I know, that this has affected. In addition to that, I would research the policies, I just do not care enough to do that. I know that obamacare has helped some people, but it is restricting some from quality healthcare. In otherwords, many doctor's offices, urgent cares, and pharmacies, do not accept it. I do not frequent CVS, or Walgreens, mostly because they are so impersonal. I mean no disrespect to you at all, this is just my feeling, based on my experience with it, through a few doctors, patients, etc.

[Inner Surfer Girl 12,015]

Here is a link to a story on NPR from 2013 that also delved into healthcare costs http://www.npr.org/2013/08/07/209585018/paying-till-it-hurts-why-american-health-care-is-so-pricey

[Jersrose43 837]

This is obviously very important to you. If I felt it necessary to cite specific details, or if I was writing an essay, I would contact the physicians, patients, pharmacists, small business owners, etc, I know, that this has affected. In addition to that, I would research the policies, I just do not care enough to do that. I know that obamacare has helped some people, but it is restricting some from quality healthcare. In otherwords, many doctor's offices, urgent cares, and pharmacies, do not accept it. I do not frequent CVS, or Walgreens, mostly because they are so impersonal. I mean no disrespect to you at all, this is just my feeling, based on my experience with it, through a few doctors, patients, etc.

Jen I work in healthcare and I will tell you it's expensive. when you start adding millions of people with conditions that are costly that never had care before or continue to need expensive care the rest of will pay for it. That's how jnsurance works. You pay to the fund. The fund pays for someone to get care.

That said its not obamacare directly driving people out of business. It is the larger groups. If you pay attention to what is going on in healthcare you can read articles about how single hospitals are merging or selling to others. Same with doctors and same with pharmacies. The meek will die and the strong will survive.

It is fallout of ACA but NOT the a direct cause. They need to be larger because they will have te power to negotiate and command better rates from any insurance company. Not just the plans that are ACA.

This has been going on for a while. ACA sped it up to warp speed.

As I said in a way earlier post. ACA/obamacare/PPACA - didn't go far enough!!

You need to control the costs of physicians and hospitals. You need a single charge for same services in same locale. And the saw payment

Non negotiable. Otherwise we're going broke regardless of commercial, employer based, government provided healthcare.

Without cost and charge controls health care is incredibly unaffordable.

Look at Vermont. They were going for single payer health care and dumped it. UNAFFORDABLE to pay for all that care.

You have to control costs and charges.

Edited January 26, 2015 by Jersrose43