<p>Well… Other countries are able to have universal healthcare. What makes us so special that we cant have universal healthcare?</p>
<p>The idea of insurance is to protect those that need it. Are we just going to insure healthy people until they get sick? Then why have insurance at all?</p>
<p>Anecdotes personalize the healthcare debates. They are real experiences. At least I know mine are real. Lol</p>
<p>If we dont provide affordable coverage, people die.
So when we say we cant afford universal coverage while othr countries can, what are we really saying?</p>
<p>Bay, if you got cancer, you would not be too happy with that high risk policy…</p>
<p>Edit… Sorry. Did not mean to write that twice.</p>
<p>Let’s all go to Belgium. :)</p>
<p>My hip does bother me a little. Really. I fell out of a window about 45 years ago. I swear. I did not fall out of a window and hurt my hip on purpose. :)</p>
<p>By the way, I have a hip issue as well. Went to an orthopedic guy who determined it is an IT band issue. I treat it with specific exercises and stretching, which work, but I have to do them regularly.</p>
<p>But wouldn’t her husband have the option to sign up for family coverage via an exchange for the coming year? That is, can’t he decided to retire at the end of 2013, with exchange-based insurance kicking in on January 1, 2014? </p>
<p>I mean, it seems to me that you are using an example of a past problem that is fixed with ACA.</p>
<p>Bay, I think Medicare would cover a hip replacement – towards the end of the article it talks about what Medicare will pay, and that the hospitals are unhappy because the bulk of the Medicare payment goes to paying for the hardware, so there’s not much left over for the surgeon & hospital.</p>
<p>The article also seemed to say that the guy had private insurance. Medicare isn’t automatic- you have to sign up for it. I don’t know why a 67 year old would choose to stay with a private policy that excluded a pre-existing condition rather than sign up for Medicare. I can see why someone might opt to stick with employer-provided coverage if they were still working — but I don’t think that the employer plans typically have pre-existing condition exclusions. </p>
<p>So yeah, that part is something of a mystery. I think that sometimes the impulse to tell a good story in journalism leads to important details being glossed over. Maybe the guy’s private insurance was affordable precisely because it excludes pre-existing conditions, and maybe he wanted to stick with it because of its provider network – that is, maybe his doctor doesn’t accept Medicare.</p>
<p>It’s kind of similar to the other article cited speculating that the prestigious and expensive Cedars Sinai Hospital in LA might not be available on the most affordable exchange policies. </p>
<p>To me that is something of a disconnect: I’m all in favor of single-payer or Medicare for all, but I don’t think that means that everyone is entitled to whatever health care provider they choose. But I’m guessing that may be a the heart of why a 67 year old guy eschews Medicare and flies to Belgium for surgery, even though the article also notes that he was a little taken aback at the spartan nature of the hospital where he was treated.</p>
<p>Pure, unadulterated socialized medical preventative care- in Montana. Doctors paid by the hour, not by the procedure or patient - by the government directly. All staff government-paid. No profit. No insurance company. In Montana.</p>
<p>Thing is - we used to have such a system in the U.S. for Medicaid clients - through public health clinics. It saved a fortune! But is was dismantled 25-30 years ago by the you-know-whos who couldn’t stand the idea of government-paid doctors and non-profit medicine serving poor people.</p>
<p>In RI with BC/BS, there was no underwriting for coverage and one set of rates that anyone could get. They also had preferred rates(now gone starting next year) for healthy customers(application went to underwriting). Premium increases have to be approved by Office of Health Insurance Commissioner.(they often approve at lower rates). I assumed many more states were similar. Makes sense to me, healthy people pay less…and the normal rates were also affordable for direst pay customers.</p>
<p>“Rhode Island law already requires insurers to take all comers and tightly regulates the individual market, but the rates can still be very high: While the average Direct Pay monthly premium is now $518.26, and rates for the young and healthy can be as low as $100.43, for older and sicker members, they can be as much as $1,117.31.”</p>