Bernie Sanders scares me as much as Hillary

formerlyGDaisy09

catsareniice1 said:

formerlyGDaisy09 said:

catsareniice1 said:

formerlyGDaisy09 said:

I guess I'm looking at it as paying more taxes, yes. but reducing the cost of health care and college, which are huge expenses....my family spends $7,800 on health insurance premiums annually and $10,000 on student loan payments, 13% of our after tax income is $8,100....so in theory bernie's plan is still saving me money.  granted it would cost me $300 once our student loans are paid off, however his health plan would pay for a lot more than my High Deductible Health Plan...($5,000 family deductible, so it cost us $12,800 a year before anything is "covered", meaning before I have the help of co-insurance to reduce the out of pocket cost of the care I/we use).  I'd also hope that employers would pass on some of their savings from no longer offering employer sponsored health insurance plans to their employees, even if we just saw a fraction of what is paid into those health plans we'd more than break even. 

I get that there are some flaws in that math. and there are other faults with Bernie's plans (lets remember that any of his plans would have to make it through congress to actually happen). 

Then healthcare will deteriorate and there will be much longer waits. You can bank on that. No thanks! Nothing is free. There will be consequences.

Yes, there are absolutely trade offs to improving finanacial access to healthcare (I have an advanced degree in health policy and am pretty well versed in global health systems). It is totally not uncommon for patients in the EU to have to wait 6 months to a year to get in to see a doctor, but that's already happening here too (several of the MDs I work with have their next available appointments some time in September).  The problem here is that many patients who need care don't get it because they can't pay for it, then they end up seeking a much higher level of care further down their care path for things that could have been taken care of for less money if they'd had enough coverage to get it paid for earlier. there are several patients in our practice whose disease is literally spirling out of control, but they cannot pay for their drugs (at $10K a dose a lot of people would have a hard time paying for that), so their disease just gets worse...eventually they're going to end-up needing emergency surgery which will likely cost them and the hospital thousands anyways.

Really we need a system reform, I'd love to see an ACO model of care where health systems that would include things like walk-in minute clinics, primary care offices, private practices, hospitals and academic centers get paid a lump sum, based primarily on population size and a predefinded set of quality measures to care for a population of patients, so the care providers basically become the insurance company, everyone gets care and the hospital is no longer incentivized to give low value care. That deals with both the issues of access (financial and scheduling) acute issues can be seen at walk-in care centers which leaves emergency rooms clear for true emergencies like MIs, strokes, and trauma. 

I don't know anyone who waits more than one month. My parents are from Europe and would come to the states for healthcare. Always.

totally depends on what you need care for, and where in the country you live. even places in Europ have come up with ways to deal with acute issues. A good friend of mine is french, when she is in france and has something acute, her doctor keeps an open slot at the end of the day to see acute problem, you might have to sit and wait, but if she goes to the office she will be seen. 

We also underuse mid-level care providers here, nurse practitioners and physician assistants could most definitely see most acute issues to have them seen and triaged onto a higher level care providers schedule, if necessary. Their license absolutely puts them in a postion to start the ball rolling on diagnosis and treatment of most things.

short+sassy

catsareniice1 said:

 

Yes, there are absolutely trade offs to improving finanacial access to healthcare (I have an advanced degree in health policy and am pretty well versed in global health systems). It is totally not uncommon for patients in the EU to have to wait 6 months to a year to get in to see a doctor, but that's already happening here too (several of the MDs I work with have their next available appointments some time in September).  The problem here is that many patients who need care don't get it because they can't pay for it, then they end up seeking a much higher level of care further down their care path for things that could have been taken care of for less money if they'd had enough coverage to get it paid for earlier. there are several patients in our practice whose disease is literally spirling out of control, but they cannot pay for their drugs (at $10K a dose a lot of people would have a hard time paying for that), so their disease just gets worse...eventually they're going to end-up needing emergency surgery which will likely cost them and the hospital thousands anyways.

Really we need a system reform, I'd love to see an ACO model of care where health systems that would include things like walk-in minute clinics, primary care offices, private practices, hospitals and academic centers get paid a lump sum, based primarily on population size and a predefinded set of quality measures to care for a population of patients, so the care providers basically become the insurance company, everyone gets care and the hospital is no longer incentivized to give low value care. That deals with both the issues of access (financial and scheduling) acute issues can be seen at walk-in care centers which leaves emergency rooms clear for true emergencies like MIs, strokes, and trauma. 

I don't know anyone who waits more than one month. My parents are from Europe and would come to the states for healthcare. Always.

First bolded:  When all the ACA debate was going around, I read an absolutely fascinating article that talked about the amount of money spent on healthcare over a person's lifetime is largely the same for everyone.  Regardless of health conditions.  BECAUSE, people with serious health conditions early in life...might be an exorbitant cost to take care of in their 20s and 30s as compared to a healthy person of the same age...but then they don't live as long.  So then the person healthy in their youth...lives on into their 80s and 90s...and is then an exorbitant cost to take care of.

And that is the irony also.  An ounce of prevention is worth a pound of cure.  But nobody thinks past the cost right now.  I've occasionally shared this, but I was diagnosed with Type I Diabetes almost 22 years ago, at the age of 20.  And I'm a victim of that.  I've spent half that time without insurance for my "pre-existing condition".  Because, whoops, got laid off and went 30 days without group insurance, so now I have to wait one year before my new company covers my pre-existing condition.

Especially early in my career, I would sacrifice to pay for insulin...because I'd die otherwise...but anything else?  Like the doctor visits and lab work I was supposed to have 4x/year.  Checking my blood sugar 6x/day at $1/pop.  Nope.  Couldn't afford most of that.  I knew it was detrimental to my long term health, but what else was I supposed to do?  I was already working f/t AND had a p/t job.  And, while there is no way to say for certain what the full extent of that neglect will be, I'm sure it will hasten some of the very nasty and substantially more expensive complications of the disease.  Short of my getting hit by a bus first, lol.  Always a crazy possibility.

Second bolded:  Do you mean in the U.S.?  For many specialties it is substantially longer than one month.  I never dare miss or try to reschedule an appointment with my endocrinologist.  It's 2-3 months for the next opening.  My last endo. was 3-4 months for an appointment.  Two of my coworkers needed hand surgery.  About 8 weeks for their first appointment, though they did use the same doctor.  Perhaps it's just my area, but I suspect it isn't.

smerka

Development pediatricians are a minimum of 4-6 months for the first appointment.

vlagrl29

short+sassy said:

catsareniice1 said:

 

Yes, there are absolutely trade offs to improving finanacial access to healthcare (I have an advanced degree in health policy and am pretty well versed in global health systems). It is totally not uncommon for patients in the EU to have to wait 6 months to a year to get in to see a doctor, but that's already happening here too (several of the MDs I work with have their next available appointments some time in September).  The problem here is that many patients who need care don't get it because they can't pay for it, then they end up seeking a much higher level of care further down their care path for things that could have been taken care of for less money if they'd had enough coverage to get it paid for earlier. there are several patients in our practice whose disease is literally spirling out of control, but they cannot pay for their drugs (at $10K a dose a lot of people would have a hard time paying for that), so their disease just gets worse...eventually they're going to end-up needing emergency surgery which will likely cost them and the hospital thousands anyways.

Really we need a system reform, I'd love to see an ACO model of care where health systems that would include things like walk-in minute clinics, primary care offices, private practices, hospitals and academic centers get paid a lump sum, based primarily on population size and a predefinded set of quality measures to care for a population of patients, so the care providers basically become the insurance company, everyone gets care and the hospital is no longer incentivized to give low value care. That deals with both the issues of access (financial and scheduling) acute issues can be seen at walk-in care centers which leaves emergency rooms clear for true emergencies like MIs, strokes, and trauma. 

I don't know anyone who waits more than one month. My parents are from Europe and would come to the states for healthcare. Always.

Do you mean in the U.S.?  For many specialties it is substantially longer than one month.  I never dare miss or try to reschedule an appointment with my endocrinologist.  It's 2-3 months for the next opening.  My last endo. was 3-4 months for an appointment.  Two of my coworkers needed hand surgery.  About 8 weeks for their first appointment, though they did use the same doctor.  Perhaps it's just my area, but I suspect it isn't.

yes for specialists its always a 1-3 month wait here as well in the midwest.  Personally I think opening insurance across state lines would help the cost of insurance greatly.

kmurphy2131

hoffse said:

BlueBirdMB said:

hoffse said:

Ultimately I think we're looking at Trump v. Hilary, and Trump will win because Hilary is an easy target.  She has way too much baggage.  There's absolutely no way Bernie is going to sweep Super Tuesday next week.  There are too many southern states involved for that.

I think if Trump wins there will be very little that substantively happens from a legislative standpoint.  He's going to deadlock Congress.

So he'll use executive orders, and we might finally get some solid constitutional rulings on the parameters of those. 

I agree we are looking at trump vs Clinton (God help us) but I think Clinton wins. Trump doesn't win in polls against her. He is literally winning the nomination with about 10% of Americans... And everyone else hates him. It will be the battle of who is hated less but she will win. Every force in the universe has combined to give her this and I think she'll make an excellent one term president- by the the people will be worn out on the Democratic Party

I hear you, but she's such an easy target and gets flustered so easily.  Trump will take her reputation and trample all over it.  She's not going to get a word in edge-wise, and the entire general election rhetoric is going to be about her, instead of the issues.  Regardless of what she wants to talk about, Trump is going to be the one controlling the national conversation.

Regardless, I think it's going to be really close.

And I think when Trump wins the nomination, the Republican party leaders are going to need to have a serious look in the mirror to figure out how/why this happened.  They've completely lost touch with their base voters.  

Republicans need to move one from the same tired social issues.  Seriously, Roe v. Wade is not going to be overturned.  Gay marriage is here to stay.  They need to let those go and focus on things that might actually change.  The religion and guns thing has gotten completely out of hand.  Taking a hard line on immigration isn't all that palatable when there aren't many legal channels to get here, and many of us are first or second generation Americans anyway. Instead, they need to focus on things the Republicans are historically good at, like fiscal issues.  I think there are many Americans who would turn Republican if they (1) stopped trying to shove religion down everybody's throats, (2) acknowledged that nobody needs assault weapons to hunt, (3) and actually balanced the budget.

100%. I am actually going to register as a democrat when I move and have to register to vote again (I usually register unenrolled).  I just cannot vote republican.  The problem is, I actually have a lot in common with republicans, but the religion pushing & the social issues (womens rights, gay marriage) are so important to me that I just cannot stray from my liberal leanings in that sense.

BlueBirdMB

kmurphy2131 said:

hoffse said:

BlueBirdMB said:

hoffse said:

Ultimately I think we're looking at Trump v. Hilary, and Trump will win because Hilary is an easy target.  She has way too much baggage.  There's absolutely no way Bernie is going to sweep Super Tuesday next week.  There are too many southern states involved for that.

I think if Trump wins there will be very little that substantively happens from a legislative standpoint.  He's going to deadlock Congress.

So he'll use executive orders, and we might finally get some solid constitutional rulings on the parameters of those. 

I agree we are looking at trump vs Clinton (God help us) but I think Clinton wins. Trump doesn't win in polls against her. He is literally winning the nomination with about 10% of Americans... And everyone else hates him. It will be the battle of who is hated less but she will win. Every force in the universe has combined to give her this and I think she'll make an excellent one term president- by the the people will be worn out on the Democratic Party

I hear you, but she's such an easy target and gets flustered so easily.  Trump will take her reputation and trample all over it.  She's not going to get a word in edge-wise, and the entire general election rhetoric is going to be about her, instead of the issues.  Regardless of what she wants to talk about, Trump is going to be the one controlling the national conversation.

Regardless, I think it's going to be really close.

And I think when Trump wins the nomination, the Republican party leaders are going to need to have a serious look in the mirror to figure out how/why this happened.  They've completely lost touch with their base voters.  

Republicans need to move one from the same tired social issues.  Seriously, Roe v. Wade is not going to be overturned.  Gay marriage is here to stay.  They need to let those go and focus on things that might actually change.  The religion and guns thing has gotten completely out of hand.  Taking a hard line on immigration isn't all that palatable when there aren't many legal channels to get here, and many of us are first or second generation Americans anyway. Instead, they need to focus on things the Republicans are historically good at, like fiscal issues.  I think there are many Americans who would turn Republican if they (1) stopped trying to shove religion down everybody's throats, (2) acknowledged that nobody needs assault weapons to hunt, (3) and actually balanced the budget.

100%. I am actually going to register as a democrat when I move and have to register to vote again (I usually register unenrolled).  I just cannot vote republican.  The problem is, I actually have a lot in common with republicans, but the religion pushing & the social issues (womens rights, gay marriage) are so important to me that I just cannot stray from my liberal leanings in that sense.

I feel the same way, but as my gay best friend says "Right now I'm more concerned about my wallet than my marriage", so we both vote Republican.  I've been saying for years that the Republican Party needs a revamp and needs to drop the religion and social issues.  I know they've been afraid to do so because they are afraid of losing their voter base, but I think Trump is a perfect example of how even the right wing evangelists don't care if their politicians push social agendas or are religious.

I have a love hate relationship with politics here in NH, but we are a secular state and our Republicans are just my type of Republican- no religion, no social issues.  

vlagrl29

Yeah I wish there was a party that was fiscally conservative and socially liberal.  That's how I feel I am.

catsareniice1

vlagrl29 said:

Yeah I wish there was a party that was fiscally conservative and socially liberal.  That's how I feel I am.

Me too!!! I vote R because of fiscal reasons, national security mainly. I am liberal on social issues with the exception of abortion in many cases.

formerlyGDaisy09

short+sassy said:

catsareniice1 said:

 

Yes, there are absolutely trade offs to improving finanacial access to healthcare (I have an advanced degree in health policy and am pretty well versed in global health systems). It is totally not uncommon for patients in the EU to have to wait 6 months to a year to get in to see a doctor, but that's already happening here too (several of the MDs I work with have their next available appointments some time in September).  The problem here is that many patients who need care don't get it because they can't pay for it, then they end up seeking a much higher level of care further down their care path for things that could have been taken care of for less money if they'd had enough coverage to get it paid for earlier. there are several patients in our practice whose disease is literally spirling out of control, but they cannot pay for their drugs (at $10K a dose a lot of people would have a hard time paying for that), so their disease just gets worse...eventually they're going to end-up needing emergency surgery which will likely cost them and the hospital thousands anyways.

Really we need a system reform, I'd love to see an ACO model of care where health systems that would include things like walk-in minute clinics, primary care offices, private practices, hospitals and academic centers get paid a lump sum, based primarily on population size and a predefinded set of quality measures to care for a population of patients, so the care providers basically become the insurance company, everyone gets care and the hospital is no longer incentivized to give low value care. That deals with both the issues of access (financial and scheduling) acute issues can be seen at walk-in care centers which leaves emergency rooms clear for true emergencies like MIs, strokes, and trauma. 

I don't know anyone who waits more than one month. My parents are from Europe and would come to the states for healthcare. Always.

First bolded:  When all the ACA debate was going around, I read an absolutely fascinating article that talked about the amount of money spent on healthcare over a person's lifetime is largely the same for everyone.  Regardless of health conditions.  BECAUSE, people with serious health conditions early in life...might be an exorbitant cost to take care of in their 20s and 30s as compared to a healthy person of the same age...but then they don't live as long.  So then the person healthy in their youth...lives on into their 80s and 90s...and is then an exorbitant cost to take care of.

And that is the irony also.  An ounce of prevention is worth a pound of cure.  But nobody thinks past the cost right now.  I've occasionally shared this, but I was diagnosed with Type I Diabetes almost 22 years ago, at the age of 20.  And I'm a victim of that.  I've spent half that time without insurance for my "pre-existing condition".  Because, whoops, got laid off and went 30 days without group insurance, so now I have to wait one year before my new company covers my pre-existing condition.

Especially early in my career, I would sacrifice to pay for insulin...because I'd die otherwise...but anything else?  Like the doctor visits and lab work I was supposed to have 4x/year.  Checking my blood sugar 6x/day at $1/pop.  Nope.  Couldn't afford most of that.  I knew it was detrimental to my long term health, but what else was I supposed to do?  I was already working f/t AND had a p/t job.  And, while there is no way to say for certain what the full extent of that neglect will be, I'm sure it will hasten some of the very nasty and substantially more expensive complications of the disease.  Short of my getting hit by a bus first, lol.  Always a crazy possibility.

Second bolded:  Do you mean in the U.S.?  For many specialties it is substantially longer than one month.  I never dare miss or try to reschedule an appointment with my endocrinologist.  It's 2-3 months for the next opening.  My last endo. was 3-4 months for an appointment.  Two of my coworkers needed hand surgery.  About 8 weeks for their first appointment, though they did use the same doctor.  Perhaps it's just my area, but I suspect it isn't.

Dr. Atul Garande's 2009 New Yorker Article is an amazing read, It compares health care costs in McAllen, Texas (expensive) to those in Rochester, MN at the Mayo Clinic (less expensive) and highlights many of the things that are so wrong with the cost of care and how we pay for care in this country. Stephen Brill's article in Time Magazine from late 2012 or early 2013 explains how the third party payer structrue is a main driver in rising healthcare costs and the absurdly inflated prices on hospital chargemasters. I recommend pairing either article with a large glass of merlot, because both will make you angry. 

vlagrl29

catsareniice1 said:

vlagrl29 said:

Yeah I wish there was a party that was fiscally conservative and socially liberal.  That's how I feel I am.

Me too!!! I vote R because of fiscal reasons, national security mainly. I am liberal on social issues with the exception of abortion in many cases.

It also seems the Ds have become more liberal as time has gone on. I consider myself independent listening to both sides before I place my vote.

short+sassy

formerlyGDaisy09 said:

 

Dr. Atul Garande's 2009 New Yorker Article is an amazing read, It compares health care costs in McAllen, Texas (expensive) to those in Rochester, MN at the Mayo Clinic (less expensive) and highlights many of the things that are so wrong with the cost of care and how we pay for care in this country. Stephen Brill's article in Time Magazine from late 2012 or early 2013 explains how the third party payer structrue is a main driver in rising healthcare costs and the absurdly inflated prices on hospital chargemasters. I recommend pairing either article with a large glass of merlot, because both will make you angry. 

Thanks for the recommendations!  Perhaps I'll drink a couple glasses before I start reading, lol.

Another good example of absurdly inflated prices.  I buy my insulin from a Canadian online pharmacy.  Exact same brand, exact same medication, exact same amount of medication.  US pharmacies...the cost starts a $250/per.  Canadian pharmacy...$135/per.  Just a shy bit over 1/2 the price.

formerlyGDaisy09

short+sassy said:

formerlyGDaisy09 said:

 

Dr. Atul Garande's 2009 New Yorker Article is an amazing read, It compares health care costs in McAllen, Texas (expensive) to those in Rochester, MN at the Mayo Clinic (less expensive) and highlights many of the things that are so wrong with the cost of care and how we pay for care in this country. Stephen Brill's article in Time Magazine from late 2012 or early 2013 explains how the third party payer structrue is a main driver in rising healthcare costs and the absurdly inflated prices on hospital chargemasters. I recommend pairing either article with a large glass of merlot, because both will make you angry. 

Thanks for the recommendations!  Perhaps I'll drink a couple glasses before I start reading, lol.

Another good example of absurdly inflated prices.  I buy my insulin from a Canadian online pharmacy.  Exact same brand, exact same medication, exact same amount of medication.  US pharmacies...the cost starts a $250/per.  Canadian pharmacy...$135/per.  Just a shy bit over 1/2 the price.

perfect example. the US price is a reflection of the discount that pharmacies expect they'll be giving to insurance providers paying for the medication; almost no one except cash payers (i.e. the uninsured and those on HDHPs) pay the actual prices of things in the US, and while most hospitals are non-profit entities they still need to make a small margin to keep their doors open, so their prices get inflated in anticipation of the discounts negotiated with insurance companies. 

In canada there are fewer payers (I believe they're on a province-based health system) so in most cased hospitals/pharmacies are dealing with one state administered health insurance plan (and everyone is covered) so in most cases they know exactly what they're getting paid for every service and medication dispensed, so there is no need for them to inflate prices to protect their margin. 

BlueBirdMB

It's amazing how no realizes how much cheaper it can be to pay cash.  I have been uninsured in the past and I just paid cash... for a tiny percentage of what the insurance company would have paid.  I still have a very high deductible, so knowing that a procedure or visit will go towards my deductible, I will often pay cash, then get the the receipts and send them into the insurance to be processed towards my deductible.  I'm in the middle of a bit of a health crisis right now, and that's how I've been handling everything.  It's been much cheaper. 

formerlyGDaisy09

BlueBirdMB said:

It's amazing how no realizes how much cheaper it can be to pay cash.  I have been uninsured in the past and I just paid cash... for a tiny percentage of what the insurance company would have paid.  I still have a very high deductible, so knowing that a procedure or visit will go towards my deductible, I will often pay cash, then get the the receipts and send them into the insurance to be processed towards my deductible.  I'm in the middle of a bit of a health crisis right now, and that's how I've been handling everything.  It's been much cheaper. 

some hospitals will give a cash discount, which hospitals offer deep discounts to cash payers usually depends on the payer mix at that hospital. the hospitals in our area are considered "critical access" and in most cases don't give discounts to cash payers because a high percentage of their payer mix are state medicaid patients and uninsured/non-payers, so they rely on private insurance and capable cash payers to make up for care that is underreimbursed or lost to bad debt. But if you're lucky enough to get care from a facility that has a higher percentage of patients with private insurance they will often offer similar discounts to what they give the insurance companies to cash payers (you're probably still paying more than an insurance company would reimburse them). 

kmurphy2131

BlueBirdMB said:

kmurphy2131 said:

hoffse said:

BlueBirdMB said:

hoffse said:

Ultimately I think we're looking at Trump v. Hilary, and Trump will win because Hilary is an easy target.  She has way too much baggage.  There's absolutely no way Bernie is going to sweep Super Tuesday next week.  There are too many southern states involved for that.

I think if Trump wins there will be very little that substantively happens from a legislative standpoint.  He's going to deadlock Congress.

So he'll use executive orders, and we might finally get some solid constitutional rulings on the parameters of those. 

I agree we are looking at trump vs Clinton (God help us) but I think Clinton wins. Trump doesn't win in polls against her. He is literally winning the nomination with about 10% of Americans... And everyone else hates him. It will be the battle of who is hated less but she will win. Every force in the universe has combined to give her this and I think she'll make an excellent one term president- by the the people will be worn out on the Democratic Party

I hear you, but she's such an easy target and gets flustered so easily.  Trump will take her reputation and trample all over it.  She's not going to get a word in edge-wise, and the entire general election rhetoric is going to be about her, instead of the issues.  Regardless of what she wants to talk about, Trump is going to be the one controlling the national conversation.

Regardless, I think it's going to be really close.

And I think when Trump wins the nomination, the Republican party leaders are going to need to have a serious look in the mirror to figure out how/why this happened.  They've completely lost touch with their base voters.  

Republicans need to move one from the same tired social issues.  Seriously, Roe v. Wade is not going to be overturned.  Gay marriage is here to stay.  They need to let those go and focus on things that might actually change.  The religion and guns thing has gotten completely out of hand.  Taking a hard line on immigration isn't all that palatable when there aren't many legal channels to get here, and many of us are first or second generation Americans anyway. Instead, they need to focus on things the Republicans are historically good at, like fiscal issues.  I think there are many Americans who would turn Republican if they (1) stopped trying to shove religion down everybody's throats, (2) acknowledged that nobody needs assault weapons to hunt, (3) and actually balanced the budget.

100%. I am actually going to register as a democrat when I move and have to register to vote again (I usually register unenrolled).  I just cannot vote republican.  The problem is, I actually have a lot in common with republicans, but the religion pushing & the social issues (womens rights, gay marriage) are so important to me that I just cannot stray from my liberal leanings in that sense.

I feel the same way, but as my gay best friend says "Right now I'm more concerned about my wallet than my marriage", so we both vote Republican.  I've been saying for years that the Republican Party needs a revamp and needs to drop the religion and social issues.  I know they've been afraid to do so because they are afraid of losing their voter base, but I think Trump is a perfect example of how even the right wing evangelists don't care if their politicians push social agendas or are religious.

I have a love hate relationship with politics here in NH, but we are a secular state and our Republicans are just my type of Republican- no religion, no social issues.  

I would be so so happy to see a candidate that met that criteria - socially liberal, fiscally conservative.  But I feel like we are getting so far from it.  Everyone is an extreme it seems. 

My brother is gay. I'd be interested to see what he thinks.  I honestly don't vote republican because I feel like I am voting against him, but I wonder what he actually thinks.  He's a mid 20's artist though, so I'm guessing he is a little liberal leaning anyway haha

short+sassy

formerlyGDaisy09 said:

BlueBirdMB said:

It's amazing how no realizes how much cheaper it can be to pay cash.  I have been uninsured in the past and I just paid cash... for a tiny percentage of what the insurance company would have paid.  I still have a very high deductible, so knowing that a procedure or visit will go towards my deductible, I will often pay cash, then get the the receipts and send them into the insurance to be processed towards my deductible.  I'm in the middle of a bit of a health crisis right now, and that's how I've been handling everything.  It's been much cheaper. 

some hospitals will give a cash discount, which hospitals offer deep discounts to cash payers usually depends on the payer mix at that hospital. the hospitals in our area are considered "critical access" and in most cases don't give discounts to cash payers because a high percentage of their payer mix are state medicaid patients and uninsured/non-payers, so they rely on private insurance and capable cash payers to make up for care that is underreimbursed or lost to bad debt. But if you're lucky enough to get care from a facility that has a higher percentage of patients with private insurance they will often offer similar discounts to what they give the insurance companies to cash payers (you're probably still paying more than an insurance company would reimburse them). 

Although I have one of those high deductible plans...really high, I think its $6850 and they pay nothing until I hit it...of course, I still get my insurance's negotiated rates.  Thank goodness.  Just like you're talking about @formerlyGDaisy09, my doctor bills always look like their jacked up just to have the insurance bring them back down to what seems like a more normal cost.

For example, in January, I had a bad cold and an ear infection.  A cold sounds so minor, but it was really bad and I had to take a week off from work.  When the ear infection developed, I went to one of those urgent care clinics that take walk-ins and are open longer than doctor's offices.

Before the insurance knocked it down, that visit was $300!!!  300 bucks!  For a 15 minute visit about an ear infection and a cold.  After my insurer's discount, the visit was $110.  Phew, much more along the lines of what I was expecting.  But, really?  2/3rds less because I have insurance?  It's not like there was a "doctor visit" going out of business clearance sale happening.

formerlyGDaisy09

short+sassy said:

formerlyGDaisy09 said:

BlueBirdMB said:

It's amazing how no realizes how much cheaper it can be to pay cash.  I have been uninsured in the past and I just paid cash... for a tiny percentage of what the insurance company would have paid.  I still have a very high deductible, so knowing that a procedure or visit will go towards my deductible, I will often pay cash, then get the the receipts and send them into the insurance to be processed towards my deductible.  I'm in the middle of a bit of a health crisis right now, and that's how I've been handling everything.  It's been much cheaper. 

some hospitals will give a cash discount, which hospitals offer deep discounts to cash payers usually depends on the payer mix at that hospital. the hospitals in our area are considered "critical access" and in most cases don't give discounts to cash payers because a high percentage of their payer mix are state medicaid patients and uninsured/non-payers, so they rely on private insurance and capable cash payers to make up for care that is underreimbursed or lost to bad debt. But if you're lucky enough to get care from a facility that has a higher percentage of patients with private insurance they will often offer similar discounts to what they give the insurance companies to cash payers (you're probably still paying more than an insurance company would reimburse them). 

Although I have one of those high deductible plans...really high, I think its $6850 and they pay nothing until I hit it...of course, I still get my insurance's negotiated rates.  Thank goodness.  Just like you're talking about @formerlyGDaisy09, my doctor bills always look like their jacked up just to have the insurance bring them back down to what seems like a more normal cost.

For example, in January, I had a bad cold and an ear infection.  A cold sounds so minor, but it was really bad and I had to take a week off from work.  When the ear infection developed, I went to one of those urgent care clinics that take walk-ins and are open longer than doctor's offices.

Before the insurance knocked it down, that visit was $300!!!  300 bucks!  For a 15 minute visit about an ear infection and a cold.  After my insurer's discount, the visit was $110.  Phew, much more along the lines of what I was expecting.  But, really?  2/3rds less because I have insurance?  It's not like there was a "doctor visit" going out of business clearance sale happening.

yup! DD's well-child visits are $265 each, and most the time that's for a weight/height check with the MA and a quick check-in with the doctor for her to say "yep! everything looks good, any questions". So greatful those are considered preventative care and paid at 100% even on the HDHP...but if she gets an ear infection or anything warranting a visit for a problem we'll have to shell out about $200 since that seems to be the discount my insurance company gets. they likely get less of a discount because there is a high proportion of state medicaid patients in our area, so the hospital has to make up for their losses there.