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Karlok - 07 February 2017 08:54 PM

Obamacare does provide healthcare to everyone sure, but it does not control the astronomical costs imposed by doctors, hospitals, pharmaceutical companies and insurance companies.

Why doesn’t it? It’s supposed to cover the costs, right?

Several reasons unfortunately. Main reason is that pharmaceutical lobbyists are some of the largest, and when Pfizer or some other pharma company pays for your election, you have to pay them back. That’s why I was so excited about Bernie Sanders, who was running only on donations from citizens, and did not take any donations from mega corps. Same goes for Trump actually, as much as I hate him, he funded his own campaign.

Same goes for big insurance companies. These companies are private and they have to keep growing and making more profits so that their stock goes up, and their shareholders profit, so they have no interest in low prices.

Another aspect is the ridiculous fees hospital charge patients. On reddit a couple of years back, a 55000 dollar bill was posted for an appendicitis operation. Now I am no doctor, but my parents both are and this surgery is one of the easiest, so to charge that amount of money is absurd. And this is not just a fluke, I have heard several other horror stories of unimaginable bills from the hospitals.

http://www.dailymail.co.uk/news/article-2532556/Astronomical-55-000-bill-appendicitis-operation-posted-online-patient-outraged-cost-U-S-healthcare-goes-viral.html

Add to that the high doctor bills, and you have a ballooning cost that just keeps going up.

I have no problem of paying more taxes so the underprivileged can get insurance, but that is not what Obamacare is. Without putting limitations on Pharmaceutical companies, insurance companies, and hospital prices, the rates are going to keep going up, and everyone poor and rich are paying for it. I don’t know how it’s like in the Netherlands but I am assuming you don’t pay $500 monthly for a decent insurance plan. These are the rates of Obamacare for somepeople, and 500 doesn’t even get you a great plan, but an average to below average one.

     
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SoccerDude28 - 08 February 2017 06:41 PM

That’s why I was so excited about Bernie Sanders, who was running only on donations from citizens, and did not take any donations from mega corps. Same goes for Trump actually, as much as I hate him, he funded his own campaign.

Agreed. I would have voted for Sanders too. Unfortunately, I’m not an American citizen. Smile

Same goes for big insurance companies. These companies are private and they have to keep growing and making more profits so that their stock goes up, and their shareholders profit, so they have no interest in low prices.

Another aspect is the ridiculous fees hospital charge patients. On reddit a couple of years back, a 55000 dollar bill was posted for an appendicitis operation. Now I am no doctor, but my parents both are and this surgery is one of the easiest, so to charge that amount of money is absurd. And this is not just a fluke, I have heard several other horror stories of unimaginable bills from the hospitals.

That’s outrageous and I don’t understand how it could happen under Obamacare. If an insurance company has to pay THAT much money to a hospital it can’t be competitive. No way. So how can it grow, make profits, satisfy shareholders, when its patients are running to a much cheaper company.

I have no problem of paying more taxes so the underprivileged can get insurance, but that is not what Obamacare is. Without putting limitations on Pharmaceutical companies, insurance companies, and hospital prices, the rates are going to keep going up, and everyone poor and rich are paying for it. I don’t know how it’s like in the Netherlands but I am assuming you don’t pay $500 monthly for a decent insurance plan. These are the rates of Obamacare for somepeople, and 500 doesn’t even get you a great plan, but an average to below average one.

Like I said in my previous post, I pay 1400-1500 Euro a year for basic insurance covering GP, specialists, hospital, maternity care, a limited number of physiotherapy sessions. (Dental care and other extras are covered in additional insurance.) Families with children pay twice as much, about 3000 a year. Never 500 a month.

Thanks for the info, very interesting.

EDIT: Read some more and found that the lack of competition is part of the problem. Important difference with my country.

     

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Karlok - 09 February 2017 08:22 PM

That’s outrageous and I don’t understand how it could happen under Obamacare. If an insurance company has to pay THAT much money to a hospital it can’t be competitive. No way. So how can it grow, make profits, satisfy shareholders, when its patients are running to a much cheaper company.

Well I know this first hand since my wife is a director of HR in a company and HR in the US handles benefits including healthcare, so here is how the crazy costs are “addressed” in the context of a company providing healthcare to its employees.

Let’s say you have an employee who has a really expensive serious disease like cancer. The insurance has to cover him, but come next year when the insurance plans are due for renewals, they can raise the prices on your company astronomically, and lower the quality of the care by providing much higher deductible plans(a deductible is a certain amount that the individual needs to pay fully out of pocket before the insurance starts covering). Now you have a company and you want to go shop somewhere else for healthcare. Other healthcare companies see you have a patient with cancer and they can either provide you with unrealistic prices or refuse to do business with you.
Now the company is left with 2 choices. Either buy the really crappy healthcare plan, or keep the good one and pay more. In my wife’s company, they actually got a really crappier healthcare plan AND with a higher price. The company has 2 choices: either make the employees pay the higher premiums to cover the costs, or cover the costs themselves. Companies like Google who are swimming in money can cover higher costs, but lesser profitable companies have to pass on the costs to the employees.

That’s how it works for companies. For individuals who are buying their own health plans and have a serious expensive disease, this is how it works. If you are healthy you can get a pretty good plan for cheap. If you are sick though, your plan is usually super expensive and pretty bad. Now you can ask well what did Obamacare do then? Before Obamacare, they could deny you coverage all together. Under Obamacare, they have to provide you with coverage, but they don’t have to give you an affordable plan - and this is where Obamacare is not good enough for me.

     
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SoccerDude28 - 11 February 2017 02:00 PM

That’s how it works for companies. For individuals who are buying their own health plans and have a serious expensive disease, this is how it works. If you are healthy you can get a pretty good plan for cheap. If you are sick though, your plan is usually super expensive and pretty bad. Now you can ask well what did Obamacare do then? Before Obamacare, they could deny you coverage all together. Under Obamacare, they have to provide you with coverage, but they don’t have to give you an affordable plan - and this is where Obamacare is not good enough for me.

I didn’t realize insurance companies are allowed to charge higher premiums for sick people. That doesn’t sound good at all. Over here everybody, healthy or sick, pays the same basis premium.

Thanks for the info! I’ve learned a lot. Smile

     

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Karlok - 12 February 2017 08:24 AM

I didn’t realize insurance companies are allowed to charge higher premiums for sick people. That doesn’t sound good at all. Over here everybody, healthy or sick, pays the same basis premium.

^ This.

Although it does go up with age, and is slightly higher under some circumstances (i.e. if you’re a smoker). I’m at 400-500 Euro per year for basic insurance. The missus is at 300-400 Euro since she’s 6 years younger and female (yes, insurance companies are sexist that way). Prices will go up when I’m 40, again when I’m 50 and they’ll be in Karlok’s insurance’s ballpark when I’m over 60.

Good thing I don’t even need to take insurance, since the missus and the kids are covered by my health insurance that’s part of my job benefits.

Oh, and as long as the kids are under 5, their medical bills are ZERO for basic care (shared hospital rooms etc.). Even the max amount I get to spend on medication for them is capped at a reasonably low amount each year.

     

The truth can’t hurt you, it’s just like the dark: it scares you witless but in time you see things clear and stark. - Elvis Costello
Maybe this time I can be strong, but since I know who I am, I’m probably wrong. Maybe this time I can go far, but thinking about where I’ve been ain’t helping me start. - Michael Kiwanuka

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Health care (and education) should be universal and free, the state should provide them. Hate insurance companies, they are a business and health shouldn’t be anywhere near them.
Karlok and Timovieman, what if people can’t pay the basic insurance?

     
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TimovieMan - 13 February 2017 02:04 PM
Karlok - 12 February 2017 08:24 AM

I didn’t realize insurance companies are allowed to charge higher premiums for sick people. That doesn’t sound good at all. Over here everybody, healthy or sick, pays the same basis premium.

^ This.

Although it does go up with age, and is slightly higher under some circumstances (i.e. if you’re a smoker). I’m at 400-500 Euro per year for basic insurance. The missus is at 300-400 Euro since she’s 6 years younger and female (yes, insurance companies are sexist that way). Prices will go up when I’m 40, again when I’m 50 and they’ll be in Karlok’s insurance’s ballpark when I’m over 60.

THAT low? Wow! I don’t know anything about health care insurance in Belgium, it’s not a subject that often comes up at parties. In Holland age and gender, even smoking, are irrelevant. Everybody pays the same basis premium (plus deductibles up to 385 euro), so I wonder how your Belgian insurance companies manage to provide care with those low premiums? 

Good thing I don’t even need to take insurance, since the missus and the kids are covered by my health insurance that’s part of my job benefits.

Oh, and as long as the kids are under 5, their medical bills are ZERO for basic care (shared hospital rooms etc.). Even the max amount I get to spend on medication for them is capped at a reasonably low amount each year.

Here health care (including dental care) for children under the age of 18 is free, i.e. covered by the parents’ premiums. Lots of differences between Holland and Belgium.

wilco - 13 February 2017 02:30 PM

Health care (and education) should be universal and free, the state should provide them. Hate insurance companies, they are a business and health shouldn’t be anywhere near them.

Tell us about Portugal?

Karlok and Timovieman, what if people can’t pay the basic insurance?

The state subsidizes, depends on your income and the amount you can pay.

     

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wilco - 13 February 2017 02:30 PM

Karlok and Timovieman, what if people can’t pay the basic insurance?

Then they’ll have to opt for minimal luxury to lower the costs (shared bedrooms in a hospital, which ensures that the doctors can’t charge an honorary fee, for instance, but also no epidural anesthesia during child birth since that’s billed for around 200 Euros). Hospital bill for child birth without complications (and no caesarean section) would end around 500 Euros for a 4-day stay that way.

But if your income is so low that you really can’t afford that, then you’re likely going to qualify for a higher medical repayment level than I do, so that bill would be lower still.

Karlok - 13 February 2017 05:28 PM

THAT low? Wow! I don’t know anything about health care insurance in Belgium, it’s not a subject that often comes up at parties. In Holland age and gender, even smoking, are irrelevant. Everybody pays the same basis premium (plus deductibles up to 385 euro), so I wonder how your Belgian insurance companies manage to provide care with those low premiums?

The basic ones aren’t covering many luxuries either, and they’re calculated based on how big the chance is that you’ll end up in hospital (hence the higher price if you’re older).
The biggest chunk of the bills is covered by the government anyway. That’s why we pay so many taxes.

Here health care (including dental care) for children under the age of 18 is free, i.e. covered by the parents’ premiums. Lots of differences between Holland and Belgium.

Dental care is free until the age of 18 as well. Possibly even 21 or 25, I forget. Regular medical care isn’t. But the government’s repayment levels are very high, so bills are going to be very low anyway.

The state subsidizes, depends on your income and the amount you can pay.

^ This.

     

The truth can’t hurt you, it’s just like the dark: it scares you witless but in time you see things clear and stark. - Elvis Costello
Maybe this time I can be strong, but since I know who I am, I’m probably wrong. Maybe this time I can go far, but thinking about where I’ve been ain’t helping me start. - Michael Kiwanuka

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TimovieMan - 13 February 2017 02:04 PM

Good thing I don’t even need to take insurance, since the missus and the kids are covered by my health insurance that’s part of my job benefits.

make sure to ask what happens when you retire or change job, up until last year the free Insurance at my company stopped if you retire and you couldn’t take it with you if you changed jobs, luckily they changed it last year.

     
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Karlok - 13 February 2017 05:28 PM
wilco - 13 February 2017 02:30 PM

Health care (and education) should be universal and free, the state should provide them. Hate insurance companies, they are a business and health shouldn’t be anywhere near them.

Tell us about Portugal?

In theory there’s a National Health System that it’s universal and free, the problem is the waiting lists (in non-urgent problems) and some parts of the country that have less health support. Somw of it works great but some parts are terrible (dental care in adults, Dermatology).
A lot of people resort to insurance and private hospitals for better confort but mostly to wait less time for some specialities.
It’s far from perfect and maybe not financially supportable since it’s changing but I do like the basis and it’s mostly well regarded and ranked (one of the few things…).

Karlok and Timovieman, what if people can’t pay the basic insurance?

The state subsidizes, depends on your income and the amount you can pay.

That’s great, just scares me when Timovimeman says stuff like an epidural is not free. That’s not a luxury. If people want to pay to have a sepparate bedroom or not wait for an appointment that’s fine but all clinical procedures should be the same.

     
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wilco - 14 February 2017 05:08 AM

That’s great, just scares me when Timovimeman says stuff like an epidural is not free. That’s not a luxury. If people want to pay to have a sepparate bedroom or not wait for an appointment that’s fine but all clinical procedures should be the same.

It’s got nothing to do with the procedure, but the medication. It’s the anaesthetics they use in an epidural that aren’t on the list of (almost-)fully government-refunded medication. It’s an exception rather than a rule. It’s just one I know of.

     

The truth can’t hurt you, it’s just like the dark: it scares you witless but in time you see things clear and stark. - Elvis Costello
Maybe this time I can be strong, but since I know who I am, I’m probably wrong. Maybe this time I can go far, but thinking about where I’ve been ain’t helping me start. - Michael Kiwanuka

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i had to say that one of BEST things about adventuregamersdotcom is giving the space for new/indie developers to open threads about their games at these forums which have become the most common thread posts, with all the befits of communicating with this sophisticated group of members that the adventure scene ever seen.. which i believe is BIG plus for the success of these games and their kickstarts (if that latter got to happen)... just saying, just appreciating.

     
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Bill Paxton has passed away at the age of 61

RIP in peace Paxton

     

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