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#133467 - 05/21/08 11:03 PM Re: Economic Approach: Fire Yourself [Re: LeeG]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
OK, I have to go with the flow.

Most of what employees think of as health insurance isn't. The employer contracts with Big Health Company ("BHC")to 'administer' the 'plan'. BHC then deals with Dr.'s, sets fees, coverage etc. They get $$ from the employer for the services, and send the employee health care bills back to the employer (in a round about way). The employer is 'self-insured', and the BHC that cuts the employer's cost in health care gets his contact renewed next year. The one that doesn't is replaced. Health care costs thus impact your employer's bottom line.

True war story. I was in a small 60 person company. The spouse of secretary had triple by-pass; the company was 'self-insured' with a big "health insurance' provider; the cost of the triple-bypass caused the company president to miss his profit target for the company that year and cost him his bonus. Then there was a lay-off and the secretary with the spouse with the heart condition was laid off.

Even with an individual health insurance policy, its like getting auto insurance with a bad driving record if you have a chronic, serious medical problem, like in our case, diabetes. If you have to ask how much the policy costs, you can't afford it. It's called "rating;" they raise your rates so basically you pay their estimate of how much you will cost them plus their admin fee and profit.

My apology for the rant guys, and the continued hijack.
_________________________
"Better is the enemy of good enough."

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#133471 - 05/22/08 12:54 AM Re: Economic Approach: Fire Yourself [Re: LeeG]
MartinFocazio Offline

Pooh-Bah

Registered: 01/21/03
Posts: 2203
Loc: Bucks County PA
Originally Posted By: LeeG

High deductible major medical is pretty inexpensive and well worth it. Sorry for the continued hijack.


Sorry, but bulls(*&7t. Double bull#@&@T.

I'm fed up with this party line, and I'm calling out any provider of a HDMM plan that actually lets you get to the dammed deductible with routine healthcare expenses and the occasional ER visit. I've been playing this game for almost 8 years now, and my attempt at humor before was actually a fairly accurate description of the sh&^&^t that I had to put up with with the HDMM plans I've tried and now that I'm uninsured, I'm seeing even more of the vast scam up close and personal.

When I was clawing my way to meet a deductible, Labcorp and Quest and the Dr.'s Offices would send the insurance company a bill - for the Dr. it was $90. Then the insurance company would "Reprice" the bill to $64. Then they would make a determination based on some arcane formula if the $64 even aplies to the deductible. More often than not it didn't, so yes, it's nice to have a lower bill, but so what? It's not going to apply to the deductible. Same goes for the Lab bills - they'd reprice the bills from $450 to $80 and then in some random formula again, some were applicable to the deductible, others not.

I had an ER visit last year, got some stuff in my eye, needed it scraped out. They repriced some, not all of the bills, half didn't apply to the deductible and all were my responsibility. An ER visit that cost me $2,400 ended up applying about $900 to my deductible.

So we went to the cash/pay as you go program, and you know what? The bastards don't care that I am willng to pay my bill on the spot with no administrative overhead on their part, no rebilling mambo - I want to pay the same $64 they would have gotten from the insurance company, but no, they offer a discount of 15% so my bill is $84. Big deal. They have already demonstrated they will take $64 for a visit, I'll give them the same for no hassle.

I'm extremely angry right now an this topic is, by my own fault, way off the rails, but the cost of HEALTH CARE is why I'm thinking about long-term economic survival at this time, and why I think it's important to discuss.




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#133474 - 05/22/08 12:58 AM Re: Economic Approach: Fire Yourself [Re: bws48]
nurit Offline
Member

Registered: 03/27/08
Posts: 191
Loc: NYC
Hi everyone. First post. Longtime lurker. You guys are terrific!

To return to the subject of cutting expenses... For years I've been buying most of my clothes at resale shops and Salvation Army/Goodwill. And lately Ebay too. This all requires time and patience, but I've found excellent things at a fraction of the original price.

Aside from the money saved, there is the joy and unpredictability of the hunt. And buying good secondhand stuff is another form of recycling.

best regards to you all
Nurit

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#133481 - 05/22/08 02:42 AM Re: Economic Approach: Fire Yourself [Re: nurit]
BobS Offline
Old Hand

Registered: 02/08/08
Posts: 924
Loc: Toledo Ohio
Originally Posted By: nurit
Hi everyone. First post. Longtime lurker. You guys are terrific!

To return to the subject of cutting expenses... For years I've been buying most of my clothes at resale shops and Salvation Army/Goodwill. And lately Ebay too. This all requires time and patience, but I've found excellent things at a fraction of the original price.

Aside from the money saved, there is the joy and unpredictability of the hunt. And buying good secondhand stuff is another form of recycling.

best regards to you all
Nurit



I bought a Kelty backpack about a month ago for $3.00 at the Goodwill store.

While out working I almost always stop in if I drive by the store. I’ve found all kinds of interesting things to play with there.
_________________________



You can run, but you'll only die tired.


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#133505 - 05/22/08 12:48 PM Re: Economic Approach: Fire Yourself [Re: nurit]
OldBaldGuy Offline
Geezer

Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
Welcome Newguy!!!

(a couple of days ago I got a pair of like-new 511 shorts at Goodwill for $1. Love those places)...
_________________________
OBG

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#133506 - 05/22/08 01:00 PM Re: Economic Approach: Fire Yourself [Re: MartinFocazio]
thseng Offline
Old Hand

Registered: 03/24/06
Posts: 900
Loc: NW NJ
Originally Posted By: martinfocazio

I'm fed up with this party line, and I'm calling out any provider of a HDMM plan that actually lets you get to the dammed deductible with routine healthcare expenses and the occasional ER visit. I've been playing this game for almost 8 years now, and my attempt at humor before was actually a fairly accurate description of the sh&^&^t that I had to put up with with the HDMM plans I've tried and now that I'm uninsured, I'm seeing even more of the vast scam up close and personal.

Insurance is GAMBLING. People think they can bet against the house and win. I don't know why.

I'm betting that my premiums will be less than my cost if I was uninsured. Even though I'm clearly losing my shirt, I stay in this game because I just might need a triple bypass one day. You can't get out of the overall game. If you don't place your bet with the insurance company, you automatically place it with Murphy. Then if you need a triple bypass, Murphy wins big and you lose everything.

You can't win. You can't break even. You can't get out of the game.

Oh, also, the game is rigged. As you described, the insurance company makes all the rules and plays their games and it is so complicated there's no way to nail them down. I love it when I ask how much a procedure will cost and they tell me "we have to do the procedure, submit the bill to your insurance and then they tell us how much you owe." B.S.

I can't understand why a doctor wouldn't give you a better deal for cash. Think of how much it costs them to process a claim with your insurance company and if they code it wrong they won't get anything! If they are lucky they'll get ten cents on the dollar from a collection agency. How do they get through medical school WITHOUT OWNING A BRAIN?

Here's what I want when the world becomes perfect: To pay for my routine, expected, reasonable medical costs with CASH. I should pay for what I get, just like anywhere else. I want an insurance policy that will cover only unlikely events that would bankrupt me in the blink of an eye and I want it priced in accordance with the likelihood that I'll need it. I don't want a "deductible" because life is too short to argue over whether a doctor visit counts for $90 or $68. I want providers go get a brain and remember why they where called to their vocation.

There are some out there. A doctor who will take your phone call, listen to your symptoms and call in a prescription for no charge. The dentist I mentioned before who took a quick look at our baby's two front teeth and didn't charge us anything (our regular dentist would have gladly taken our copay and billed our insurance, after making us wait for an hour).

_________________________
- Tom S.

"Never trust and engineer who doesn't carry a pocketknife."

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#133507 - 05/22/08 01:07 PM Re: Economic Approach: Fire Yourself [Re: nurit]
thseng Offline
Old Hand

Registered: 03/24/06
Posts: 900
Loc: NW NJ
Originally Posted By: nurit
To return to the subject of cutting expenses... For years I've been buying most of my clothes at resale shops and Salvation Army/Goodwill. And lately Ebay too. This all requires time and patience, but I've found excellent things at a fraction of the original price.

Welcome, Nurit.

We should make a list of things that are expensive when bought new compared the cost of buying them used. How about:

Cars (drive a new one off the lot and you already owe much more than its worth)
Kid's bicycles (they are almost given away at garage sales)
...
_________________________
- Tom S.

"Never trust and engineer who doesn't carry a pocketknife."

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#133510 - 05/22/08 02:02 PM Re: Economic Approach: Fire Yourself [Re: thseng]
OldBaldGuy Offline
Geezer

Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
More times than I like to think about I have been in pharmacies and seen them charge one price for an item to a person with insurance, and a different (and higher) price for the same item to a person without insurance. No insurance, you're gonna pay more. If you rarely if ever have to use prescription drugs you MIGHT save money by not paying insurance premiums, but one good illness or injury and I fear that you will be broke in no time. I just had eye surgery. The bill for the gas passer alone was over $700, discounted (thanks to my Blue Cross) to a little over $300, my out of pocket cost, $34...
_________________________
OBG

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#133517 - 05/22/08 02:46 PM Re: Economic Approach: Fire Yourself [Re: OldBaldGuy]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
Hey, maybe we need a thread/forum on surviving the health care/insurance system wink
_________________________
"Better is the enemy of good enough."

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#133536 - 05/22/08 05:27 PM Re: Economic Approach: Fire Yourself [Re: ]
KG2V Offline

Veteran

Registered: 08/19/03
Posts: 1371
Loc: Queens, New York City
RE Insurance:
Yes, you are betting against yourself - with the whole of the "group" as a base - the insurance company will NEVER (or almost never) lose against the group as a whole

An individual can occasionally "Break the Bank" (unfortunately, over the last 12 months, I've been one of those)

Generally - if you can't get seriously discounted medical (hey, my company pays for it, and won't give me more pay if I opt out, so I might as well 'play' - as I'm playing with 'funny money'), you are best off with a pure "catastrophic" plan. At one point, we had a plan - basically it covered NADA till something like $10K. The way it worked - it was basically "if you get in an accident/have something drastic happen (cancer, heart attack etc), we will pay after you rack up 10K in bills" - wan't cheap, but wasn't too expensive either. The KNEW I was not going to be submitting anything unless I/my family was in the hospital dieing
_________________________
73 de KG2V
You are what you do when it counts - The Masso
Homepage: http://www.thegallos.com
Blog: http://kg2v.blogspot.com

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