Work Reform

Even for me, with health insurance, one of the reasons I tend not to seek health care is due to the surprise and unpredictable costs. I've already fallen into that trap twice this year alone.

The very first thing I did when I was choosing a plan for this year was filter the list down to the ones I could afford which said they covered all my prescription meds and for which my current health providers were "in-network". That left 2 options.

When I went to get my first round of refills, several months into the year, they said I had to have prior authorization for one of my meds. After going through that process several times, provider who writes the prescription has to jump through the hoops with insurance to get the authorization, the insurance finally came back and said "we don't/won't cover this prescription." My provider was able to find a cheaper, older alternative that works, but I pay out of pocket 100% for it.

Then came my annual physical, which is free with insurance. Because of the meds I'm on, the nurse said they needed to do some blood tests to check for signs of problems. Never mentioned that those tests would cost me extra and obviously I did not know. Wouldn't have mattered, because they wouldn't have been able to tell me up front how much it would cost so that I could make a financial decision about it. In the end, that free annual visit cost me almost $400 that I was not anticipating. The bills started showing up months later, so it completely blindsided me.

Last year was even worse. I had one of the best insurance plans offered through the ACA. Then I had an accident that landed me in the hospital. The ambulance ride was not covered at all, the service was "out-of-network" so I had to pay 100% of that. The 2 tylenol I was given for pain management in the emergency room cost me $40 because insurance would not pay for them without prior authorization. I hesitated to even call for help, hoping I could stop the bleeding myself, because I knew it was going to be an expensive trip to the ER and boy was it ever. Not to mention the follow-up appointments and treatment that was required.

There are other reasons - one being that doctors aren't really offering treatments, just finagling their way to defining a "solution" or excuse for the symptoms you're exhibiting. Many people experiencing problems are out looking for their own solutions. I don't blame poor medical training, just the squeezing of their metrics for maximum profit.

The leadership of US medical of the last 25 years should be prosecuted, have their wealth taken from them, and their kin removed with them on a biblical scale.

The removal method? Guillotine

Thinning the herd, just as Project 2025 planned.

I've been to the doctor twice in the last 20 years and one of them was an emergency. It has been longer for the dentist.

There's also those in the opposite situation: Stuck unemployed on Medicare because getting a job would make necessary healthcare too expensive. What a country

I have not had insurance my entire adult life, because it was too expensive, and the jobs I was able to work didnt offer it. So I only go once a year, when I'm forced to in order to get my meds for the next year.. and any issues I have, I hope and pray linger until this appointment, because I cant afford to pay 200+ dollars every time i have an issue that i need a doctor for.

the only experience I've had with insurance, in my adult life, is handling an elderly relatives medical issues. They have medicare.

Medicare is fucking awesome. Anything they need, poof, its done. no delays, no awaiting approvals, just get it fucking done. Most of their drugs are free (at least until trump gets rid of part d..), and the one that isnt, is only like 5 dollars, for a 90 day supply (so 20 bucks a year for meds). They have had multiple major surgeries, and the copay was like 30 dollars each time.

Not once have they ever been told they cant have a treatment, or that they have to go through some bullshit process of trying 3 other things before they can get the treatment the doctor orders, nothing.

Medicare is fucking awesome and everyone should have it.

in another time, that would have a better chance of happening since we used to go after racketeers. now, we have them in the actual government so thats not even in consideration

It is cheaper to keep people healthy through preventive care than it is to treat illness. From a taxpayer point of view, a single payer system would save us money.

But people are so propagandized in this country that they seriously think private insurance is the better option.

All of the hospitals in my state were purchased by Atlantic Health.

My friend works for the hospital. The highlight of their quarterly meeting is how much profit the hospital now makes.

Why do hospitals need to make profit?!

Why are corporate owned hospitals even legal?!

I hate this timeline.

A lot of times, you just get a big bill without them doing anything useful for you.

People pay a fortune in premiums, then another fortune in deductibles, before they can even use their insurance. Most families never actually get to that point unless they are "lucky" enough to have a family member who gets sick or injured badly enough to meet the deductible. Then you can finally use your insurance for the rest of the year.

We paid for years, and got literally nothing out of it, until I fell off a roof and got a bad concussion, and a big enough bill that our deductible was met. That was in September, so for the next few months we went to every doctor we needed, got every test we'd been putting off, etc. It was the only time we got full use of our insurance, so we took advantage of it, after paying in tens of thousands of dollars for years.

Medicare 4 All would give us full use of our insurance on January 1 every year, without having to worry about any deductibles. It might cost a couple of hundred extra dollars in taxes, but you'll save $600 month in health insurance premium, and $4500 per year in deductibles, so you'll come out far ahead, and have actual health insurance.

This is the exact set up for a Black Plague event. I know people tend to hold a grudge over the Covid Lockdown, but do we really need to see bodies topple on the street before realisation is made?

This makes every zombie movie way more realistic than it has any right to be.

Can we please gets some socialism up in this bitch already?!

92% not going and yet I still have to wait 6-8 weeks for a visit with my PCP, to be mostly ignored and referred to a specialist, then 6+ months for a specialist to be told I need to go back to my PCP to redo all the diagnostics they did at referral because the results are too old now...

I don't have data, but as a pharmacy worker one thing that seems very apparent to me is people with non-european/white names getting way more insurance rejections.

Also, insulin and inhalers should not be so consistently headaches to deal with. Inhaler insurance issues make me want to rip my hair out.

It would be better if it actually was an open market like Japans medical system. They cap the profits on materials and treatment. They also have to list prices so you can actually compare and contrast the costs of treatment. Insurance companies are now the backbone of the US medical system, even owning and operating entire medical providers. Their business model is to maximize profits and deny care wherever possible. It'll be difficult to dismantle that relationship now.

I just spent 5grand out of pocket because the doctor made me take a sleep test. They charged insurance nearly 20 grand.

They told me they found nothing and I was fine. I pointed out some flaws in their test but they weren’t interested in my opinion.

I cancelled my follow up appointment bc I can’t afford it, at least until this is paid off.

Also, I am not fine. I am very very tired.

Did you know if you meet your deductible they will won’t pay until you also meet the Out of Pocket Maximum? What’s the point of the deductible? I have no idea.

Instead of prosecution couldn't the executives be dissolved too?

Just think of all the missed revenue in both insurance and medical sectors /s

And they are still paying for that insurance they can't afford to use.

I've been putting off allergies/sinus issue for a bit, just to hoping it would go away on its own. This morning I woke up with a sore left ear and jaw. I could hear the bubbling in my ear. Took some Ibuprofen and Acetaminophen to help. The pain returned by lunch. Decided to go get it looked at on insurance. Still cost $310 to get some Amoxacillian prescribed. I am fortunate to be able to afford it and yet it still hurt me financially.