the-future-of-medicaid-may-be-found-in-indiana-where-the-poor-pay

[Orlong]

You must be living in a different US. My parents, a 65 year old and a 62 year old with a 19 year old, have to pay 25k/year for their insurance, and they are in a network.

They can pay more and not have a network or get a job that offers a better plan. I pay $11 per paycheck and have no network requirement

[Zephyr Storm]

Again, cutting your own taxes and just taking more federal dollars to balance the budget does not count as being in the "black". A 1/3rd of Indiana's state budget is subsidized by federal dollars. And for every dollar a resident there pays in federal taxes they get $2.03 back. As far as any reasonable person would understand Indiana is a debtor state that is being subsidized by wealthy coastal states like California, New York, etc.

And yet, some of those wealthy coastal states receive just as much of a percentage of their yearly revenue from the federal government (and some of them receive more) as Indiana does.

And sorry, but staying in the black, even with federal aid, is still pretty noteworthy. Considering other states (some of them democrat controlled) can't stay out of the red, even with the federal government giving them just as much of a percentage of their yearly revenue as Indiana gets (and sometimes more). Indiana must be doing something right, don't you think?

[Total Crica]

And yet, some of those wealthy coastal states receive just as much of a percentage of their yearly revenue from the federal government (and some of them receive more) as Indiana does.

So, the only issue is really that you want more crematoriums/prisons to be built for all the poor people who can't afford healthcare?

And people wonder why no one accepts jobs that won't keep them healthy and instead turn to gangs and crime?

Nature is going to kill them off anyway, why would they work for people who have no interest in helping them stay healthy?

[alexw]

https://www.cato.org/blog/how-much-d...-federal-funds

It's from 2013, but shows that California is almost as much as Indiana and New York is actually more than Indiana. So what's that about the big, democratically controlled coastal states? Just as much, if not more of their yearly revenue comes from federal aid as Indiana's does.

Lol lol lol.

You are actually quoting the cato institute as if its a credible source?

[araine]

Its about principle. People shouldnt get anything that they didnt earn. Especially when its paid for by other people who have no choice but to pay extra so someone else can get something for free. You want something? then earn it

certain things are a right such as right to education and right to healthcare but you will never agree to these OBVIOUS things, you probably want schools to be for profit as well and that noone of those poor fuckers should get educated since we need burger flippers anyway kinda mentality of the far right

[alexw]

So, the only issue is really that you want more crematoriums/prisons to be built for all the poor people who can't afford healthcare?

And people wonder why no one accepts jobs that won't keep them healthy and instead turn to gangs and crime?

Nature is going to kill them off anyway, why would they work for people who have no interest in helping them stay healthy?

Just ignore his posts. He's quoting the CATO institute. Its 90% complete BS.

[BeatdownBrigade]

And yet, some of those wealthy coastal states receive just as much of a percentage of their yearly revenue from the federal government (and some of them receive more) as Indiana does.

And sorry, but staying in the black, even with federal aid, is still pretty noteworthy. Considering other states (some of them democrat controlled) can't stay out of the red, even with the federal government giving them just as much of a percentage of their yearly revenue as Indiana gets (and sometimes more). Indiana must be doing something right, don't you think?

Most recent analysis of this I could find from the US Tax Foundation and US Census Bureau was from 2013. Your post is from the 2011 Fiscal year. As stated Indiana received $2.03 dollars for every federal tax dollar they gave, California for example received $0.73 for every federal tax dollar paid. Indiana's state budget was 33.4% federal funds, above the national average of 29.7%. California's state budget was only 24.9% the 8th lowest in the country. So to avoid the argument of either of us cherry picking. In the 2011 Fiscal year you posted California was 32.4% of their budget and Indiana was 34.5%.

2012: California 27.2% and Indiana 32.3%

So two of the three most recent years California has been well below average as a percentage of their state budget. Not to mention again they are actually giving money on every dollar ($0.73 back for every dollar spent, compared to $2.03 in Indiana) so those federal dollars are more theirs to begin with than Indiana's.

As it goes without saying based on state GDP's ($2.5 trillion in California, compared to 350 billion in Indiana), California and the raw dollars they earn while giving 0.27 on every dollar to the federal government are paying for many states, including Indiana, to have things such as lower taxes, balance their budgets, etc.

[Iamanerd]

I mean why should you get free healthcare just because you want to be worthless and not work? I had to pay full price for insurance until Obama got ahold of it, it was affordable and good coverage, then Obamacare happened and my Insurance was going to cost $2000.00 per month... Fuck that, so I dropped it and haven't had coverage in 2 years. The yearly penalty has been less than 1 months premium, so If they really expect me to pay for everyone's health insurance then I better get excellent converge not 12k deductible.

You're so full of shit, 2k/mo premium with a 12k deductible? I call bullshit on this, there's no fucking way even with a family you're paying this.

[Zephyr Storm]

You're so full of shit, 2k/mo premium with a 12k deductible? I call bullshit on this, there's no fucking way even with a family you're paying this.

I can attest to at least the monthly premiums going into absurdly high ranges under Obamacare. My father, who is self insured because he's self employed, has had his current monthly premiums go up to around $2000. And it's slated to go up even more here in 2017. He tried opting for a higher deductible in order to decrease the monthly premiums, but insurance told him that if he did that, it would disqualify him from their coverage and he would be forced into the health exchanges setup under Obamacare. He looked into the exchange and found out the cheapest plan available to him would still cost him the same amount in monthly premiums but ALSO increase his deductible at the same time. So the worst of both worlds for the only plan he's eligible for.

Obamacare may be great for people who never had insurance before. But for people who could afford it before, they're being charged out the ass to the point where they can't hardly afford it anymore.

[Iamanerd]

I can attest to at least the monthly premiums going into absurdly high ranges under Obamacare. My father, who is self insured because he's self employed, has had his current monthly premiums go up to around $2000. And it's slated to go up even more here in 2017. He tried opting for a higher deductible in order to decrease the monthly premiums, but insurance told him that if he did that, it would disqualify him from their coverage and he would be forced into the health exchanges setup under Obamacare. He looked into the exchange and found out the cheapest plan available to him would still cost him the same amount in monthly premiums but ALSO increase his deductible at the same time. So the worst of both worlds for the only plan he's eligible for.

Obamacare may be great for people who never had insurance before. But for people who could afford it before, they're being charged out the ass to the point where they can't hardly afford it anymore.

How many people are on that plan for $2000/mo premium and what kind of coverage, I'm not sure how age affects it which I'm sure it does (I'm only 25 myself). I pay $300/mo off exchange for a decent plan but nothing crazy and has a $4000/yr deductible.

[medievalman1]

How many people are on that plan for $2000/mo premium and what kind of coverage, I'm not sure how age affects it which I'm sure it does (I'm only 25 myself). I pay $300/mo off exchange for a decent plan but nothing crazy and has a $4000/yr deductible.

Not sure of all the details, but my mother's insurance premiums will go up from around $1400 to $2000 next year. Annual deductible is at least 10k. Granted, this is still better than what she was paying for insurance prior to the ACA when she was paying high premiums AND over $1000 a month for insulin...

- - - Updated - - -

The first thing we need to do is throw people who who go to the ER for the flu or a runny nose the hell out so people with real emergencies dont have to wait hours. This will also reduce the amount other people pay for the poor people going to the ER for things thry shouldve went to a regular doctor office or bought OTC meds for. The truly poor already qualify for medicaid so they shouldnt be a drain on resources

Yeah, having the flu-as in, actual influenza-and going to the ER isn't necessarily a bad thing, as can be deadly. With that said, there is a lot of abuse of the ER system, as the ER cannot turn away anyone due to the insurance/ability to pay or lack thereof.

One of the main issues with medicaid, in Oregon at least, is the lack of primary care doctors that will accept it in their practice. Because there are a relatively few number of them, it is quite difficult to see a doctor in a timely manner. Thus, the only reliable means to obtain medical care is through an ER. Many Urgent Care facilities won't accept medicaid either, and they are not bound under EMTALA like an ER and can turn away people if they can't pay/don't have insurance that pays (i.e. not medicaid). And so, again, people turn to the ER.

I really don't care, cause Doctors cost real money and send real bills. I have a friend who is slow and doesn't understand things and he's on medicaid. He smokes a fuck load, and had pain in his right side. I'm 5 minutes away from 3 hospitals, and I've taken him to two, into their ER. First ER dismissed him and prescribed him a cream. Second one said, "This isn't a Doctor's Office, we don't do check ups". At that point I told the person to at least look into it harder cause he chain smokes and it could be cancer in his lung. They did an X-Ray and sure enough, exactly what I said.

I know people that work in the ER are overworked and understaffed, but your job is to save lives, not to redirect people like customer service. If you want to take your frustration on something, complain about the healthcare system itself. I wouldn't have a problem taking my friend to a Doctor, if it wasn't always about seeing if the Doctor took his MediCaid. Cause they usually don't. Every Doctor I call has to make sure they take the insurance, and if they do it takes like a week just to go into the office. When you have a problem, you want it taken cared of immediately.

I'm skeptical of parts of your story (a cream for "side"-probably should define the location a bit better-pain?). Regardless, taking your story at face value... an ER isn't going to fix cancer. You know what they will do? tentatively diagnose you and send you on your way with a referral for follow up. A referral that isn't necessarily covered by the insurance, especially one like medicaid. You know who could've done the same thing? The PCP. Yeah, it might have taken a number of days/weeks to get into the office, but again, you're not going to fix cancer in a day. Now, if your friend had respiratory distress, on top of his "side" pain, ok, sure. That would've been an emergency situation, one that would've caused emergent treatment, and likely an aggressive plan-possibly emergency surgery.

Here's the deal, emergency rooms are for emergencies. Healthcare workers are fed up with people that come for something that isn't an emergency (like calling an ambulance for an ingrown toenail-I've personally seen patients do just that on 4 different occasions in less than 3 years), and then get pissed to the point of being disruptive/aggressive/violent because they believe their sprained ankle/cyclic-vomiting-due-to-marijuana-use/fibromyalgia/migraines should take priority over less vocal/visibly sick individuals that come in with stroke-like symptoms, or symptoms indicative of cardiac problems.

[Gorgodeus]

Except thats the price insurance pays. If you tell them up front that youre a cash customer, you get a much cheaper rate.

Wrong. You might be charge a little less if you are uninsured, but it is not "much cheaper". That is a fallacy.

[Fugus]

My dad runs his own business with 3 employees. Not big enough to get his own plan, he just gets fucked over.

Yeah, Orlong is a stage act from what I can tell and from what I have heard. Either that or the biggest hypocrite on the planet as he is in a government union shop freeloading off all they got while being against unions and about anything that actually helps people but at the same time refuses to leave for another job on principle because his union job gives him better than the non-union jobs do.

He is basically a hypocritical scab or a stage act on here. From all I have seen, I am leaning more towards a stage act.

[Iamanerd]

How the fuck is anyone paying $2000/mo in insurance premiums? That's more than a fucking mortgage on a house.... Something is seriously wrong with these prices or else things are different here in CT because I don't know anyone in my family or friends or co-workers who pays that or anything above $800/mo. Seriously my boss who's 55 pays $800/mo for really good insurance with a deductible that's $1500/yr and it covers a shit ton.

[TirielWoW]

I like my health savings plan. My employer puts $4-5 thousand a year into my account and I put about $1,000. I can spend this money on any health need, dental too.

If I leave my job I still have the account.

I mean...okay?

So almost exactly a month ago, I went to the emergency room with severe back pain and intense acid reflux. I was admitted that night, because my gallbladder had 2cm diameter stones in it. One of those stones had attempted to pass out of my gallbladder, and broken apart once in my bile duct. It ended up blocking my common bile duct, and I didn't know it, but the bile was building back up into my liver and I was becoming jaundiced. Had I not gone to the ER that night, there's a very real possibility that my gallbladder could have turned gangrenous, and I could have died. In fact, I was in the process of doing that, and had no idea.

I was in the hospital for four days. I had IV antibiotics every 6 hours the entire time I was in the hospital, plus three more days of antibiotics once I was out. I had two surgeries - one to clear the blockage in my bile duct and place a temporary stent in to hold it open, and the other to actually remove my diseased gallbladder. While they were doing the gallbladder surgery, they discovered severe endometriosis on my upper and lower abdominal walls (which is important, because literally the only way to officially diagnose endometriosis is to have exploratory laproscopy, which I have now avoided thank god).

So far - and this hasn't included the actual gallbladder surgeon, the ER bill, or the hospital bill itself - the bill for my care is at over $10,100.

I owe approximately $365. My insurance covered everything else.

In two weeks, I have to go back in and get an outpatient procedure done to remove the stent currently in my bile duct. I have no idea how much that will cost, but I do know that I would be bankrupt if I had to rely on an HSA instead of a comprehensive health plan. And I thank god every day that I made the smart decision and chose to pay $130 a month for the best possible plan my employer offers. (Incidentally, while I'm paying $130 a month, my employer is actually forking over ~$240 a month for me.)

I honestly cannot imagine what I would have done if I had an HSA instead of the plan I'm on. I would be royally fucked.

[RaoBurning]

So far - and this hasn't included the actual gallbladder surgeon, the ER bill, or the hospital bill itself - the bill for my care is at over $10,100.

Frankly I'm a bit surprised the bill came out that low for everything you had done. I had a CT scan, a shot of morphine, and an IV of saline in the ER (kidney stone, turns out) and it ran me $12,000 that the hospital will never see. If I had that kind of money sitting around I'd have insurance.

I'd have stayed home and just chewed on something for a few hours if I'd known I wasn't dying

[TirielWoW]

Frankly I'm a bit surprised the bill came out that low for everything you had done. I had a CT scan, a shot of morphine, and an IV of saline in the ER (kidney stone, turns out) and it ran me $12,000 that the hospital will never see. If I had that kind of money sitting around I'd have insurance.

I'd have stayed home and just chewed on something for a few hours if I'd known I wasn't dying

That's the initial stuff. It's the anesthesiologists, the gastric surgeon who put the stint in, all of the consulting doctors and nurses, and the bill for the MRI, CAT Scan and two Ultrasounds they did. It doesn't include the hospital bill itself (for the room, the operating rooms, supplies, etc), ER bill, or the bill for the surgeon that actually cut into me.

That's what they billed Blue Cross, of course. Blue Cross didn't pay them even half that.

[TirielWoW]

Big companies manage to negotiate down the premiums that insurers charge them so most people working at a big company are fine. But if, like my dad, you're independent, your negotiating power is nil so you get hammered.

I can speak to this. My company has over 20,000 employees. That's why I have 3 different healthcare options, and one of them is very very good, one middling, and one kinda crappy.

[Captain N]

I can speak to this. My company has over 20,000 employees. That's why I have 3 different healthcare options, and one of them is very very good, one middling, and one kinda crappy.

What's the variation of the prices in each of those? A Company of that size should be able to easily subsidize the price of a good plan for it's employees if they make insurance coverage mandatory. I know that was one of the big things where I work. Mandatory insurance at $200/month...add as many people to the plan as you want....everyone ended up subsidizing everyone else and it kept the out of pocket maximum to a decent $2500 as well.

[TirielWoW]

What's the variation of the prices in each of those? A Company of that size should be able to easily subsidize the price of a good plan for it's employees if they make insurance coverage mandatory. I know that was one of the big things where I work. Mandatory insurance at $200/month...add as many people to the plan as you want....everyone ended up subsidizing everyone else and it kept the out of pocket maximum to a decent $2500 as well.

The cheapest plan is $25 every two weeks. The most expensive plan (the one I'm on) is $65 every two weeks. It's going up to $68 or $70 in 2017, but I forget which.