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I know this is a sore subject with some on here. But I have some questions about how Obama care works. I was talking to a friend of mine and she asked me about it. Some people were talking about their son who is 17 or 18 and was diagnosed with Leukemia. A rare form that usually only infants get. The treatments and medications are really expensive. They signed up for Obama care so Medicare - Medicaid would pay for the medication. They were told that M/M would not pay for it because it is a terminal condition and that the money spent should go to people that will live and go on to productive lives. Now that's not word for word but that is the reason given for turning them down. My friend said she thought that maybe she was taking it wrong or she misunderstood what she heard, so she started asking around to find out more. Here's where it gets scary. She was told by some people that the elderly were being "phased out"  . It seems that if you are an older person, then their meds. are being cut back and they are shipped off to another room to expire. The more questions she asked the more its starting to sound like a doomsday book. Anyway, can somebody tell me how Obama care works for those elderly or terminally ill patients? Is this really the way were going on heath care? Thank You for any info. you can give.
Dawginit since Jan. 24, 2000 Member #180
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I would suggest you look up the UK's NHS. That is pretty much the model you will see. They have a 'fast track to death' for seniors. There are 6 months+ waiting lists to see a doctor. My granddaughter (3) was refused a cast for a broken arm. My daughter had to make the kid a sling. Depending on which part of the country you are in, you are refused chemotherapy where other parts of the country have plenty of the same treatments. Unfortunately, that kid appears to already have a ruling from the 'death panels' that weren't supposed to exist.
On a side note, my brother was diagnosed with Hodgekins disease when he was about 18. This is a form of leukemia that usually strikes the young. I was his bone marrow donor when the treatment was still experimental. He went through several experimental treatments when the bone marrow transplant didn't take. He was a lab rat for several years before he finally gave up. If what you are saying is 100% true, I guess we won't see experimental treatments and research anymore.
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I have my same insurance I've always had from my employer so I've not paid a whole lot of attention to the circus of obicare. Certainly though from what I've heard you can't be turned down for a pre-existing condition. Now if the insurance companies have to take you but don't have to pay for treatments, who is determining what treatments they do and do not have to pay for and if they aren't paying, what is the point of having to purchase insurance?
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Thanks for the info. But that still begs the question....Is this the way we are going in heath care? I find it hard to believe. Is it going to only the rich get good care and the poor die? Or is that an exaggeration?
Dawginit since Jan. 24, 2000 Member #180
You can't fix yesterday but you can learn for tomorrow
#GMSTRONG
I want to do it as a Cleveland Brown because that's who I am.”
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Quote:
Now if the insurance companies have to take you but don't have to pay for treatments, who is determining what treatments they do and do not have to pay for and if they aren't paying, what is the point of having to purchase insurance?
That is the question. I don't know if the kids parents had insurance or not, it sounds like they did not. However, Eric brought up a good point about which state you live in and some cover better than others, is that a state law? I don't know, I just know that the more I hear about some people being turned down and others not, I wonder what is going on. Whats the point in paying for insurance if they don't pay? Starting to sound like it's a scam to just get your money, and if it's law now then it's blackmail.
Dawginit since Jan. 24, 2000 Member #180
You can't fix yesterday but you can learn for tomorrow
#GMSTRONG
I want to do it as a Cleveland Brown because that's who I am.”
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Quote:
Thanks for the info. But that still begs the question....Is this the way we are going in heath care? I find it hard to believe. Is it going to only the rich get good care and the poor die? Or is that an exaggeration?
My understanding is: just because an insurance company can't turn you down doesn't mean they can't charge you more, make the deductibles higher, and, sadly, determine what treatments are covered.
The ACA is totally reliant on young, healthy people paying for insurance they won't use, to offset sick people, those with pre-existing conditions, and the elderly. Hey, that's what ANY insurance is based on - sell enough good policies to offset the bad policies. I get it. Home insurance, car insurance, health insurance - any insurance is based on that.
Where this whole thing will lead is to premiums and deductibles that are simply un affordable, as many are finding out already.
That will lead to single payer, which will lead to the fed. gov't. being in charge. And that leads to the gov't. looking at dollars in and dollars out, and making decisions on that alone.
Sure, everyone has insurance at that point. But, where do you get care? You're sick? Eh, sorry man, take a pain pill.
I could go on and on - but the example by the o.p. is possibly/probably going to become the norm sooner rather than later.
I understand, and know, that health care/insurance needs to be changed. No doubt about that. The problem is, the aca isn't doing what needs to be done. It's a feel good thing which, in the end, isn't going to feel good.
Insurance companies are already concerned about the future premiums.
http://nypost.com/2014/04/01/insurers-fear-backlash-over-new-obamacare-rate-increases/
That's just one article, take it for what it's worth.
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Actually insurance companies have always been in control of what medications/treatments they decide to either cover or not.
Nothing has changed there and it has always been that way with or without Obamacare. The two are in no way related.
The real problem I see with Obamacare is that it still allows health insurance companies to dictate such things and still be the power behind it all. One of the largest problems people had with health care before Obamacare was rising premiums, ever increasing deductibles, and having treatments/medications being turned down by the insurance companies.
Obamacare did nothing to address this.
Intoducing for The Cleveland Browns, Quarterback Deshawn "The Predator" Watson. He will also be the one to choose your next head coach.
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Thanks Arch, good info. It sounds like Real estate. Location....location...location. It's a mess. Sounds like the ACA determines who lives and who dies.
Dawginit since Jan. 24, 2000 Member #180
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Quote:
Actually insurance companies have always been in control of what medications/treatments they decide to either cover or not.
Nothing has changed there and it has always been that way with or without Obamacare. The two are in no way related.
The real problem I see with Obamacare is that it still allows health insurance companies to dictate such things and still be the power behind it all. One of the largest problems people had with health care before Obamacare was rising premiums, ever increasing deductibles, and having treatments/medications being turned down by the insurance companies.
Obamacare did nothing to address this.
Exactly. Precisely. We still have the same problems, only worse.
But, at least 7 million people signed up for insurance, right? Of the 30-50 million we were told didn't have insurance. And of those 7 million that applied, how many actually are paying? Or did some of them enroll, only to say "I can't afford that", and never pay.
We'll never know.
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I agree Pit, This has been a problem long before Ocare. It just seems to be coming out more now. It seems our lives are nothing more than pot luck if you get sick or ill.
Dawginit since Jan. 24, 2000 Member #180
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Quote:
The real problem I see with Obamacare is that it still allows health insurance companies to dictate such things and still be the power behind it all. One of the largest problems people had with health care before Obamacare was rising premiums, ever increasing deductibles, and having treatments/medications being turned down by the insurance companies.
Obamacare did nothing to address this.
The actual problem is that you are not allowed to chose your own policy. Before obummercare, the states dictated what you had to be covered for and who you could be covered by, and now the feds have determined that. I don't need maternity care in my policy anymore, along with tons of childhood disease prevention. I still have to pay for it. Right now, being about 50, I need catastrophic care, wellness care, and coverage for potential problems down the road that come with old age. I should be able to buy insurance the same way I do auto insurance, where I can pick and choose my level of coverage, and what company I deal with. That would make it cheaper for me and everyone else.
I would actually prefer to be able to start my own health savings account, that was not overseen by a governing body. That way I could pay my doctor cash. Can you imagine the savings for the doctors if they didn't have to hire a huge staff for all the paperwork they have to do. They'd actually be able to practice medicine instead of practicing paperwork for potential audits.
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I can't answer your questions Arch. To me, if you were going to have a national healthcare system, there should be no insurance companies involved. Much like the plans in Europe.
The half aced attempt that was made falls far short of anything that would have ever have resolved the problems that already existed.
I don't know about Obamacare making the problems "worse". I look at it like everything else. Big business looks for any excuse to gouge consumers.
I look at food prices. When fuel costs make a drastic rise, they use that as a valid reason to raise food prices. Yet when fuel costs go back down, do they in turn cut food costs? No, they don't. Then when fuel costs spike again, they use the exact same excuse to raise food costs and the cycle continues.
Any time a business or a perception that people have which perceives that cost will go up, business uses it to raise prices. I believe the problem is far more that insurance companies are using the excuse of Obamacare that Obamacare itself.
Intoducing for The Cleveland Browns, Quarterback Deshawn "The Predator" Watson. He will also be the one to choose your next head coach.
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A couple of things
Obomacare raised the standard for all private insurance policies to a higher level than with prior state level policies which varied. That is why we have the no preexisting condition and lifetime caps, well care, and other benefits that may not have been included as part of prior policies. So the base policies will be more expensive.
Lower income people get subsidies in order to help offset the cost of Obamacare. So the premium is the same, but the subsidies vary based on your income level.
For those who's income is below the Obamacare threshold, Medicaid, not Medicare kicks in. That is a different program with different insurance criteria. Medicaid is normally a state run program, which is the contention about Medicaid expansion. The federal government was willing to pick up 100 percent of the cost initially then 80 percent of the cost after a few years. Some states, mostly southern and republican ones said no.
I don't know much about Medicaid, but I question the information that you were provided.
Obamacare and Medicaid are separate ways to get insurance. Obamacare is through a private carrier, Medicaid is a state level insurance program for low income people. I can't reconcile how someone could sign up for Obamacare to obtain a Medicaid benefit. There may be some crossover, but I don't think so.
The rest of the stuff sounds like the death panel stuff that has been debunked time after time.
I would suggest talking to someone that actually understands the programs.
Many of the stories about Obamacare have proven were intentionally misleading and later proven to be false.
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Thank You Charger. I know it sounds a bit over the top. Was why I was asking. You bring up a good point about state and government run programs. I don't know the facts as to what pertains to what, but it does not make any sense as to why M/M, one or the other would deny benefits in this case unless it was a state law and not a federal one. Maybe this state denies all such illness's and some people want to blame the Gov.? I don't know but thanks for sharing the info.
Dawginit since Jan. 24, 2000 Member #180
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I will address your last point about the elderly on Medicare a couple of ways.
I suspect that there are limits to the type and cost of treatment versus potential to recovery and lead a quality life. If not, the cost of Medicare would be even higher. That could be interpreted by some as being harsh, but it is balancing the probable outcome versus cost. Remember this is a government program, and although we all paid into it, some will receive more benefits than others.
I am sure that there are some that would intentionally "adjust" the parameters in order to save money, or limit the criteria by which the elderly obtain extended Medicare care. So one take on the denial of costly extended care is that it is harsh. Of course if you are in a situation where you are willing to try anything, being told that you don't qualify for costly treatment under Medicare won't sit too well.
So, it is a matter of perspective. I had a friend who was 78 at the time, that "They say the average person lives until they are 79, when you are 40, you think about it differently than when you are 78.
My dad passed about 28 years ago. Six months before he had a really bad stroke that paralyzed his right side but did not affect his mental capacity and he was bedridden. We I last saw him he requested that they not put him on a ventilator as it was very uncomfortable. After talking to the nurses they indicated that his request was not unusual, but they could and would go the extra distance if he so desired. Four days later, his next journey began. It remains one of the life changing events for me.
Welcome back, Joe, we missed you!
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Quote:
But, at least 7 million people signed up for insurance, right? Of the 30-50 million we were told didn't have insurance. And of those 7 million that applied, how many actually are paying? Or did some of them enroll, only to say "I can't afford that", and never pay.
And if you don't have insurance and didn't sign up for Obamacare,you get fined 1% of your income and the fine is no less than $95.00 from what I understand.So you are being forced to buy something you may not even want and if you don't buy it,you get fined like you did something wrong and are some kind of criminal.
Biggest crock of you know what I have ever seen.The Govt. can't even take care of the people on Medicare right now,so how are they gonna take care of the health insurance needs for the whole country?
I have been on Medicare since last July and it took me 2 months to get everything straightened around where they screwed mine up.They had themselves down as my secondary insurance and my insurance from work was my secondary insurance so I had 2 secondary insurances and no primary which Medicare was supposed to be.Was real fun talking to them trying to get this straightened out.
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bleednbrown, 1 Side is more concerned with scaring you than helping/informing you. "Phased Out" is a good clue!
There are plenty of organizations that focus on helping people, not misguiding them. Tell your friend to seek out these resources. Under the ACA, the 18 year old should be able to find a private insurance policy and possibly get help paying the premium. Call the insurance company directly if you fear The Obama! They will gladly help you.
Medicare is the program for 65+. Its been around for decades. That scary, doomsday book? Its a fiction novel.
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Quote:
Actually insurance companies have always been in control of what medications/treatments they decide to either cover or not.
Nothing has changed there and it has always been that way with or without Obamacare. The two are in no way related.
The real problem I see with Obamacare is that it still allows health insurance companies to dictate such things and still be the power behind it all. One of the largest problems people had with health care before Obamacare was rising premiums, ever increasing deductibles, and having treatments/medications being turned down by the insurance companies.
Obamacare did nothing to address this.
There's all sorts of things that ObamaCare mandated be covered and there were changes to pre-existing conditions. Look at the birth control issue.
My premium went down in 2011 b/c Blue Cross was taking huge profits on my policy. It dropped $40 and hasn't gone up a penny since. $1500 saved and counting. No cost to you either. I pay for my own without a subsidy. Healthcare costs have slowed quite a bit from the prior decade. They were going up 10% per year before ObamaCare.
Its not perfect. But there have been quite a few improvements, many the GOP are backing now. Quite a shift from their 2010 threats.
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Ask a certified insurance health care professional in your state. You aren't going to get correct info here.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." Thomas Jefferson.
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