<p>Aren’t most health care costs about prolonging life? Anytime you treat a cancer, or heart disease, or hypertension, or diabetes, isn’t it about prolonging life?</p>
<p>It’s not unusual for hemophiliacs to run up medical bills of $500K or even $750K per year. You do the math; it doesn’t take many years at that pace to burn up a $6 million lifetime cap, and many had caps much lower. I suppose we could say, “Let 'em bleed; we’re just prolonging life,” but that seems awfully calloused. Many hemophiliacs can lead pretty normal, happy, and productive lives if they’re careful, get the right (and often very costly) treatments, and have access to the urgent medical care they almost inevitably will need from time to time.</p>
<p>I don’t know a single person who hit some of these limits but I probably don’t know that one in 10,000 or rather I don’t know 10,000 people personally. I would think there are actuarial metrics somewhere showing how many hit their limits or exceeded on an annual basis.</p>
<p>If there was a cap until two three years ago, how did all these people get to live? What exactly happened when they reached the million dollar cap? Do they still pay off the millions 200$ a month for generations?</p>
<p>What you are describing (your first sentence) is not completely true. For example, we all know you cannot buy health insurance without caps, even if you wanted :). </p>
<p>Anyway, one of my favorite quotes is: </p>
<p>There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences.</p>
<p>Texas, They got no treatment after their insurance ran out for anything, or they ran up bills they couldn’t pay and then filed for bankruptcy (another thing we all share the cost of when it happens.) And some died.</p>
<p>One of my wife’s best friends paid for her cancer treatments over several years. Her husband had a very good job. She had a very good job and was able to go back to work. I dont know if caps were the issue or if parts of her treatment were not covered. Lookingforward and BClintonk are providing very good links.</p>
<p>GP yes Anthem. My premiums were over 1200 a month in 2011. I doubt you looked at my plan. :)</p>
<p>I hope you looked at lookingforward’s link. The calif section is very interesting.</p>
<p>Well, some do–but only if they qualify for Medicaid, and not everyone who exceeds their lifetime cap is eligible for Medicaid. This Washington Post story from a few years back relates the story of a family with 3 children with hemophilia who had exhausted their individual lifetime caps under the parents’ employer-sponsored health insurance. As children, they then qualified for Medicaid, but as soon as the oldest hit 18 he was no longer eligible for Medicaid, unless he could get himself classified as “disabled” which was no sure thing at the time of the writing of the article.</p>
<p>Some may have gotten to live based on what the Mass General financial report called “charity” to support patients. An uncle of mine got his costs covered (at least, in part) by the American Cancer Society. (Ages ago, no idea if this is still done.) Major children’s hospitals raise funds to help support what families cannot afford. There is fundraising on the front end to underwrite some clinics, reduce service delivery costs. This isn’t a simple vacuum.</p>
<p>But, plenty would find themselves selling the house, making major life changes, able to pay one thing at the sacrifice of another. Or not able to share the costs of what is recommended.</p>
<p>But I want to say something about keeping our doctors. Mine is my age and will retire in a few years. I dread changing, but will. DH had to change when his beloved and superb doc got a national fellowhip. Docs move, some change focus, reduce hours, go into teaching. Some, when you develop particular needs, move you to another primary relationship that can better handle your needs.</p>
<p>I had a highly reputed gyn- when he cancelled a few too many appts (I swear, he was more interested in sailing, once his kids graduated college,) I switched-- and found the new doc was superior. Hmm.</p>
<p>Who says we get to keep them forever? Or that our trust and affection are always rightly placed?</p>
<p>Yes, this is my understanding about medicaid. The under-21 crowd is eligible for it, and the over 21 disabled crowd is eligible for it. While I don’t know anything about hemophilia specifically, my understanding is that many (or most) people who are incurring $1mill per year bills for health care are more than likely not able to work, and thus qualify as disabled for purposes of medicaid coverage.</p>
<p>Not “for generations.” Most of this debt is personal; it dies with the debtor and isn’t passed on to the next generation (though there could be liens attached to property that would otherwise pass to the next generation).</p>
<p>Some people do make good faith efforts to pay it off. Some declare bankruptcy. Some just stop paying, knowing that since they’re essentially broke they’re pretty much judgment-proof. Some skip out on their bills, taking up a new life in another state. Some sell off their homes or other valuable assets. Some rack up big credit card bills, or take out second mortgages, or refinance their mortgages to pay their medical bills–stopgap strategies that tend to compound their debt problems, leading in many cases to bankruptcy. Some stop taking their medications, or put off medically necessary treatments or surgeries, which in many cases compounds their medical problems. Some try to save on the cost of surgeries or other treatments by going overseas. Some are able to enroll in Medicaid. which doesn’t in itself relieve them of debt, but it does give them access to at least some medical care going forward.</p>
<p>I can’t remember what my Blue Shield policy limits were pre-2010, but I do know that in the years around ~2001 I paid for a second, supplemental policy that was essentially umbrella health coverage – it only kicked in when health care costs exceeded something like $100K- and then it was either unlimited cap or had very high limits like $20 million or something. It was relatively cheap, about $75 a year, and I think available via the state bar association or some other lawyer group-- I wouldn’t have bought it unless there was something in my basic policy that led me to think that the limits were too low. (For example, I also now have umbrella coverage to supplement the liability limits on my car and homeowners policies)</p>
<p>Edit: OK, now I’ve dug up a plan summary from 2006- a Blue Shield HSA-eligible policy, lifetime max $6 million. I have an inkling of a memory of the lifetime limits being lower in 2001 when I bought the supplemental catastrophic - I’m guessing about $1 million – and I’m thinking I probably dropped the high-end catastrophic when lifetime limits were increased on the underlying policy. But I don’t think that $6 million is enough for a lifetime in a worse case scenario. (Would it be enough for cancer or a brain tumor?). The “Lifetime” part is scary because cancer has a way of going into remission after treatment, and then coming back later on. As a buyer on the individual market I never would have had the option of simply switching to a different plan and a new “lifetime” max – any disease that could run up the max limits would also be a disqualifying pre-existing condition for any future disease. $6 million isn’t that much - it’s more money than I’ve ever had or seen at one time, but I can see it getting exhausted with a long-term hospitalization and multiple surgeries.</p>
<p>“There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences.”</p>
<p>That basic right doesnt exist unless that human lives alone and doesnt have human contact and that human doesnt make or leave a footprint anywhere.</p>
<p>Smoking for example…GP may like to smoke. Lerkin, you may not want to breathe smoke filled air. There is going to have to be a compromise.</p>
<p>GP… You cant smoke. ;)</p>
<p>One person’s basic rights infringes on another’s basic rights many many times. </p>
<p>There are also societal rights. That is where ACA comes into the picture.</p>
<p>Outside of the ER, most people will not be able to get millions of dollars worth of medical care without proof of insurance or paying, which leads me to believe that the prevalence of this happening is probably very small.</p>
<p>As LF mentioned, there are resources for people with no insurance or money who need treatment to get treatment. But I cannot speak to everyone’s experience with this.</p>
<p>of course, the rights cannot exist without consequences. That is what the quote was about.</p>
<p>And yes, I agree: “One person’s basic rights infringes on another’s basic rights many many times.” But, we should strive to minimize this. </p>
<p>I like your example about smoking. People have a right to smoke, as long as it does not interfere with other people’s right to breath clean air. Smokers should also accept the consequences of their actions, and thus I have no problem with smokers paying higher rate for their health insurance.</p>
<p>This is scary (to me) – I wouldn’t count on my medical bills dying with me. Even if they did, unpaid catastrophic bills could wipe out my estate and anything I otherwise had to leave to my kids and grandkids. I’m not rich, but I am a homeowner – I’d hate to see my kids burdened with the task of selling my home and contents, knowing that all proceeds would go to unpaid medical bills.</p>
<p>Calmom, you should have kept that supplemental policy. It would be grandfathered today and probably would have covered all your out of network costs under ACA.</p>
<p>It is a fact that no health insurance plan in Ca that I am aware of did not have a lifetime caps pre-2010. The $6 million on your 2006 policy is what I had, too. It would have been nice if the insurance companies offered unlimited lifetime policies at some price point prior to 2010.</p>
<p>I would like to see some statistics regarding how many people actually exceeded the $6 million cap or the caps in other states. We can speak anecdotally but with out some facts it is mostly noise.</p>
<p>Interesting. I had never heard of this. Fortunately, neither my mother, nor my mother-in-law, nor DW & I live in states with such laws. Something to think about when we retire, because I wouldn’t want to saddle my kids with my old-age medical bills.</p>
<p>I’m skeptical that these laws are enforced very often, but even the threat that they could be is enough to keep me from taking up domicile in any state with such a law.</p>
<p>You didnt see lifetime caps during or after after 2010 because of ACA. That is a difficult concept for you to grasp GP.</p>
<p>“When will the removal of life-time caps take place?
Immediately for new policies, and in six months for existing plans and policies, called “grandfathered plans” in the language of the bill.”</p>
<p>It wasnt that expensive to do away with the caps per policy.</p>
<p>That can be a slippery slope. Everything in one way or another could be viewed as infringing upon the rights of others, particularly when invoking the “societal rights” claim.</p>