<p>It’s not a matter of the type of insurance I would prefer. Rather, it’s the type of regulation I prefer, versus the typ of regulation the insurance companies would prefer. They would prefer less regulation, so that they can screw the consumer. I would prefer not to be screwed.</p>
<p>Companies always gravitate to the state with the least regulations when they can. Most big corporations incorporate in Delaware, because it has laxer regulations. Amazon for a long time avoided state sales taxes by setting up shop in no-tax states. Insurance companies will avoid setting up shop in states with strong consumer protection, if they can, and sell across state lines, if they can.</p>
<p>A lot of this speculation is covered in links on 5/16. This isn’t just about marketability. Right now, insurers have to be licensed in a state to operate there. In theory, if that Alabama company met Oregon’s standards, it could be feasible to sell there. But do the insurers want to come up with plans that meet multiple states’ needs? Maybe yes, if it’s easy and profitable. Maybe not, depending on the complexity and disparity in different states’ add-on regulations. </p>
<p>Obviously, companies like Blue Cross now work in multiple states. And we all have business dealings with companies out of state. One of my mortgage companies was in CA- they were beholden to particular related laws in my state. Same for the time we financed a car- my state laws about loans trumped. In contrast, some out of state home insurers won’t operate where I am, because of some specific regulations here.</p>
<p>CF, although I have given you a hard about not having an Obamacare policy, in all seriousness take the Cobra policy for the next 18 months. Trust me, you don’t want the individual plans that are currently being offered today. We can have all the hypothetical discussions you want about this law, but this is your life we are talking about and the Obamacare plans are not ready for prime time as of now. Do yourself a favor and do what is best for you and your husband. Don’t make a bad decision because it might conflict with your ideological beliefs.</p>
<p>Nope; never have written anything close to such a thing. (Nice try.) I’ve been in witness to the relevance of acupuncture in Chinese open heart operating rooms.</p>
<p>But acupuncture comes with an additional cost. Moreover, only a small % of the population desires it. Just like only a small % of the population have kids in college out of the service area.</p>
<p>Plans that cover benefits that only a small % are interested in costs more. From a public policy perspective (ask cost), where do you draw a line? Should the childless have to pay extra so dietz’ friend’s kids can get coverage while they go off to college? Should those that attend the local juco have to pay extra so kids can go away to college?</p>
<p>Why not let folks pay a rider for such extra out-of area coverage, or even acupuncture? </p>
<p>I suspect that quite a lot of people are interested in acupuncture. From a public policy standpoint, I would not use popularity to draw the line at all, for acupuncture or for any other treatment. I would certainly pay to treat rare diseases and conditions. Instead of looking at popularity, I would use these three criteria:</p>
<p>Is it effective? Acupuncture might or might not fall afoul of this criterion, but first I’d go after certain surgeries with no beneficial effects, like stents in non-acute cases and certain kinds of popular back surgeries.</p>
<p>Does it treat something we should be paying to treat? Boob jobs “work,” but I’m not paying to treat someone whose health problem is that they don’t think their boobs are big enough. </p>
<p>Is it cost-effective? There may be a million-dollar pill that works exactly as well as Advil. Sorry. Take the Advil.</p>
<p>I’m skeptical about acupuncture. I’m not going to take a position here about whether it should be covered by California insurance companies, but I doubt that an inexpensive treatment that few people use is adding much to California insurance costs. If it’s inexpensive and not widely used, the total cost has to be small, and the cost per subscriber tiny.</p>
<p>Big California based fan of acupuncture here! However, the way health insurance coverage works is pretty useless. You limited to 12 acupuncture and/or chiropractor visits per year (some plans combine these). And, you have to first meet your deductible. So unless your per treatment cost for acupuncture/chiropractic runs between $208 to $416 per visit (based on a $2500 or $5000 deductible) it’s a pretty useless feel good coverage. This is not even accounting for the reworking of a visit charge to extract those service/ items not covered. Needle insertions - covered, Moxa/cupping treatment eh…not necessarily. Chiropractic adjustment - covered, cold laser treatment to ensure treatment takes - eh not so much. </p>
<p>Oh…but it gets better. My out of pocket - put it on the credit card - cost per visit to the chiro is $65. However, when we had an auto accident it was billed to the at fault drivers insurance. Guess what - bills out at $400/visit. Same for workman comp claims. Please folks. look under the hood, kick the tires…the nice paint job is a misleading vernier.</p>
<p>Mental health coverage - well kind of - first 3 visits covered. THEN you need a psychiatric evaluation and diagnosis - so no going to a counselor for, say, a bad case of the teenage ‘ain’t it awfuls’. Nope, that kid will have to get a diagnosis - what’s your preference - bipolar, depressive, mood disorder, social maladjustment…pick one and your insurance will cover continued visits. </p>
<p>If this acupuncture talk takes its natural course (ie, “I think…” met by "yes but I think…,) you’ll fast see why it is not universally covered. Everyone has a different experience and there isn’t enough that follows the standards for medical evaluation. You can argue that, but it’s not that the medical community is so vehemently opposed. (At least not in New England and California.) Add to that, most treatments come in sets, which immediately runs up the costs. </p>
<p>You can get mental health attention without some rigmarole. Yes, you need to read your policy. In fact, in choosing, that was a consideration for us because D2 has a psychiatrist. What can be confusing is when there is an oversight process that asks the doc to reverify continued need. No big deal. Ime, possible diagnosis comes on visit #1. It doesn’t have to be big and scary, just follow DSM. </p>
<p>Wow. Great explanation of the useless benefits, Dietz. So, if you couldn’t afford it before you probably can’t afford it now. Although, it’s covered. Sigh.</p>
<p>Again, I’m not taking a position on whether acupuncture should be covered. But:</p>
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<p>You don’t have to meet your acupuncture deductible, though. There’s just one deductible for everything. You might have already used up the entire deductible with surgery or something, and then your 12 acupuncture visits would be covered.</p>
<p>Yup. No coverage for seeing a counselor because you happen to be going through a tough time at school, because you’re dealing with friendship/acceptance/it’s hard to be 15, 16,17,18/bullying issues. In order to continue talking to a professional you need a diagnostic code. And, by gosh we will find one for you and put it on your permanent record!</p>
<p>The people I know who use chiropractic and acupuncture care tend to either be proactive - trying to prevent certain issues - or are trying to manage a long term pain issue. Neither of these cases lend themselves to ever hitting the deductible. So in effect, all chiro and acupuncture is out of pocket.</p>
<p>Well yes, you are in fact taking a position: by outlawing OOS medical insurers, your position is that the California regulators get to choose what is best for its taxpayers, without the opportunity for residents to choose a plan elsewhere.</p>
<p>Chiropractic services currently are NOT covered under Covered California plans. Acupuncture is. It’s just a policy decision made in California – there’s a lot of leeway under ACA for states to set their own regulations when it comes to alternative care. </p>
<p>I am quite sure of the chiropractor issue because I do see a chiropractor – it’s one reason I benefit from an HSA, as I can use the HSA dollars to pay the chiropractor even and many non-covered benefits. It has been a huge help to see the chiropractor – but a visit to the chiropractor is not much more than the co-pay on many policies. (About $40). The monthly fees for the yoga studio (recommended by the chiropractor) are $90 --not considered a medical expense, but a savings over the individual class rate. A visit to my hairdresser can easily run $75 up – not a medical expense, but just provided here as something that can be lumped under “things I pay for that make me feel good.” </p>
<p>So while I kind of wish my insurance would pay for the chiropractor --who certainly has done a lot more for me in the past year than the medical doctor – I can live with handling that cost on my own.</p>
Body dysmorphic disorder is a recognized mental health diagnosis. So then the boob job should be covered. Why would you choose to not treat that particular mental health diagnosis ? </p>
<p>Seems like someone who was dealing with chronic pain might well reach their deductible with whatever treatments they get for the condition causing the chronic pain. The deductible for the acupuncture is just the regular deductible for all their medical costs, so they could meet it with six acupuncture visits and a lab test.</p>
<p>It’s interesting how so many smart people don’t understand the ins and outs of private insurance. I was just talking to a friend of Mr. Fang’s, who bought a policy on the private market. He was warning me about how private insurance differs from the employer insurance he was used to. “Some things just aren’t covered,” he said. “My doctor recommended a chest x-ray and I had to pay for it!” </p>
<p>I had to explain the difference between treatments that are not covered, like the ice cream my doctor would recommend to me for a sore throat, and treatments that are covered but are subject to a deductible, like chest x-rays.</p>
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