Health Care Thread

Not seeing an easy searchable version netwise, I have access to a Chargemaster summary which while a few years dated has the max allowable per procedure at $20k for cancer treatment for Lumenos OH. Lumenos CA is $40k. For comparison a Medicaid program I recognize from here in MD has $75k.

Also some of the summaries I saw seeing if there was an easily searchable one, which there isn't, seems to imply some services are exempt unless paid for out of the HSA, so pseudo optional if true didn't read further than the summary but that's how it was talking about cancer costs.

Vaclav_sl said:

Not seeing an easy searchable version netwise, I have access to a Chargemaster summary which while a few years dated has the max allowable per procedure at $20k for cancer treatment for Lumenos OH. Lumenos CA is $40k. For comparison a Medicaid program I recognize from here in MD has $75k.

Also some of the summaries I saw seeing if there was an easily searchable one, which there isn't, seems to imply some services are exempt unless paid for out of the HSA, so pseudo optional if true didn't read further than the summary but that's how it was talking about cancer costs.

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Thank you for the information. I will call Anthem tomorrow to verify the cancer treatment limits. As for paying out of the HSA, my deductible/out-of-pocket max is only $1500 - so it's pretty simple to put $1500 into an HSA anyway. I will also verify this.

In your previous post, you indicated you got this information from the Anthem website and the info I sent in PM. I see now you have changed the story - you got your information from a system the public cannot access. Very convenient.

Nothing in my evidence indicates that I am not covered for the services you claim, as you now admit. You cannot provide evidence to the contrary. You have claimed that the evidence I provided supports your case, when now you must admit nothing in the evidence I provided supports your case.

On this basis, you essentially call me a nutcase in your last post.

I assumed it would be public, perhaps it is - but I'm not seeing it - when dealing with stuff that is private like Chargemaster records it's usually best to sidestep them - would've been better to check first, on the latter I didn't read any deeper into it. And this is basically a long Excel that I'm using (really long... 4k entries on just the HSA page that I found it on...) and I'm not sure how it was entered if it was hand-done, maybe someone dropped a zero here and there no idea. (although the CA one being similar does tend to make me think it's not - two errors of dropping a zero shouldn't happen almost back to back)

And note: wasn't meaning you were crazy, just comparing how annoying it's being talking to you to talking to a crazy person (Lumie). He battens down the hatches and refuses to budge contrary to how things are presented. Much like how you still haven't acknowledged the dozens of services out of your exclusion list that ARE ACA included (almost the whole list besides cosmetic is - and technically cosmetic clauses on ACA are less harshly written - that writing seems to throw out scar treatment which the ACA does cover [big deal for me, so I watch that one specifically a lot - digital syndactyly is a fun thing - and usually scar tissue treatments are covered by MOST but it's a good litmus in my experience for a plans total quality when they restrict cosmetic completely rather than limiting it to specific categories of cosmetic, similarly cleft pallets fall under cosmetic surgery as well])

And of course there's the whole thing that exempts any PEC although that's probably dated, thought those clauses are dead, no?

**edited, new post.

Vaclav_sl said:

And note: wasn't meaning you were crazy, just comparing how annoying it's being talking to you to talking to a crazy person (Lumie). He battens down the hatches and refuses to budge contrary to how things are presented. Much like how you still haven't acknowledged the dozens of services out of your exclusion list that ARE ACA included (almost the whole list besides cosmetic is - and technically cosmetic clauses on ACA are less harshly written - that writing seems to throw out scar treatment which the ACA does cover [big deal for me, so I watch that one specifically a lot - digital syndactyly is a fun thing - and usually scar tissue treatments are covered by MOST but it's a good litmus in my experience for a plans total quality when they restrict cosmetic completely rather than limiting it to specific categories of cosmetic, similarly cleft pallets fall under cosmetic surgery as well])

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I did acknowledge that there are services ACA provides that my policy doesn't. Very early I mentioned it does not over maternity. I sent you the PM with a list of services not provided under my policy. How am I not acknowledging them?

I have acknowledged these limitations; I did so when I sent them to you. I maintain that the plan is comprehensive medical. You reply not comprehensive medical because it doesn't pay for cosmetic surgury. Wow.

You'll have to forgive us, bro. We're still waiting on confirmation that you're not the same ACA-hating, "Obama is weak!," never-met-a-conspiracy-theory-he-didn't-like dipshit who skulked away a few days ago after it started to look like he lost his ban bet.

Sebudai_sl said:

You'll have to forgive us, bro. We're still waiting on confirmation that you're not the same ACA-hating, "Obama is weak!," never-met-a-conspiracy-theory-he-didn't-like dipshit who skulked away a few days ago after it started to look like he lost his ban bet.

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Um ... O.K.

It's true I don't like the ACA; I think our old system needed reform badly, but the ACA is a bad deal, not because I oppose offering affordable coverage to the poor and disabled (I am fine with helping to fund their healthcare), but because it seems to impose too great a burden on already struggling middle class. (see the NYtimes article I linked earlier)

Obama is not a particularly weak U.S. president, although his adminstration has made some foreign policy blunders recently. However, name a president that hasn't? I am far more embarassed about the WMD lies our government spread to start a war in Iraq, than Obama's 'red line' thing. In fact, I am very happy Obama didn't attempt more direct intervention in Syria or the Ukraine, as I think it could have blown up into a larger war. I don't like wars.

Conspiracy theories? Like what? I haven't mentioned any, and I try to use respected sources.

TJT_sl said:

I work for a Fortune 500.

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Can you explain this in more detail.

Most Fortune 500 give a 80% contribution to healthcare so using your post employer cost as any litmus is hilarious. You are likely paying one fifth of what you see coming out of your check.

Frk: Scar repair falls under cosmetic and it's a very wide thing, skin grafts if you get a third degree burn are considered cosmetic for insurance coding for Christ's sake. Cosmetic insurance coded treatments run a wide range, some of which are life threatening to skip like skin grafts or scar adjustments in my case. (My scars have to be retouched any time my fingers grow, shrink or otherwise change too much since scar tissue doesn't grow too much change literally has my fingers tear the flesh between my fingers open - sounds sensible for an insurer to ignore, right? And yes, it does happen summer camp as a kid, swimming in the pool it occurred - and that was with me having 18 surgeries on them already at age 12 or so...)

It's not supposed to eclipse employer healthcare. So comparing it to something it's not supposed to beat or match is ludicrous and demonstrates a fundamental misunderstanding - it's nice for the rare cases it does but those are outliers that weren't part of the intent.

And the ACA is beneficial for you in less visible ways like PEC changes.

You could be dropped or rate adjusted for PEC before too you do realize, right? It's not just for starting a policy - I lost mine when I became disabled, blaming it on my genetic condition that of course predated the policy.

And they were different, that was considered to be the status quo and not screwed up along with Medicare as such both received minimal changes - the uninsured, worthless catastrophic policies, Medicaid, and individuals buying single policies were the targets to bring them in line with employer healthcare and Medicare.

You don't even seem to understand the basics and are just "mememe'ing" ignorant to how screwed up things were for those other groups.

And note average premium was projected to raise 30% this year preACA (7-8% was normal, and there was a 4 year freeze so sounds a sensible estimate to me) - average increase this year 14% instead. Another less visible success you benefit from.

Less than what it was projected to if the ACA wasn't enacted, not under its own projections. Thus the preACA qualifier - before the law was even passed to try to make estimates based on it. (It did come in under its own as well, but only slightly 16% projected vs 14% actual IIRC)

You keep trying to interject negativity into it, normally in a debate like this is it's a slow and steady method of working a message in. And being that this was already a debate, I treated it as such. If it was just meant as a non sequitur I could see your point, but your steady responses don't really bear that out.

I'm not demanding.. I was just curious how of the workaround the HDHP requirement and the answer of "i work for a fortune 500" just made you sound like an ignorant dick.

You do have a $1500 deductible, and your employer contributes 1500 to your healthcare each year -- that is a much more accurate assessment and actually better than having a 0$ deductible because if you don't do shit you still end up with $1500 in your pocket assuming you're single.

frqkjt_sl said:

Eomer, I do have to ask, why so angry?

I did nothing but present my experience with ACA and make some basic deductions. Anyone is welcome to refute me. Yet you call me a racist, take my comments out of context, etc. Your life is short - why spend it here insulting me? If you think I have limited understanding of market theory and government, fine.

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I get angry when fuckwads like you, with zero experience outside of your own bubble, start throwing around terms like "socialist slave nations". It makes you look like an ignorant asshole, because you are one. People of your ilk defend this "free market mantra" with no actual knowledge of how other healthcare systems work, and unfortunately, a lot of people who are equally ignorant will buy in to your fear mongering and keep supporting a shitty system that completely fucks most people over. Get this: the US health care system is so fucking shitty, it pissed me off, even though it doesn't even affect me.

Eomer_sl said:

I get angry when fuckwads like you, with zero experience outside of your own bubble, start throwing around terms like "socialist slave nations". It makes you look like an ignorant asshole, because you are one. People of your ilk defend this "free market mantra" with no actual knowledge of how other healthcare systems work, and unfortunately, a lot of people who are equally ignorant will buy in to your fear mongering and keep supporting a shitty system that completely fucks most people over. Get this: the US health care system is so fucking shitty, it pissed me off, even though it doesn't even affect me.

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Eomer, what you do is this - you skim posts, not comprehending everything, and post angry knee-jerk reactions. On this very page, I wrote this:

It's true I don't like the ACA;I think our old system needed reform badly, but the ACA is a bad deal, not because I oppose offering affordable coverage to the poor and disabled (I am fine with helping to fund their healthcare), but because it seems to impose too great a burden on already struggling middle class. (see the NYtimes article I linked earlier)

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Furthermore, I will say this for the last time: I don't think Europeans are socialist slaves. I was defending free-market enterprise, after I perceived a poster equated profits with corruption.

**edit to add:

Vaclav:
Let's say you are correct about medically necessary cosmetic procedures, for the sake of argument. This is now the only problem with my policy (vs what you consider comprehensive) that you can provide any proof of.

$349 ACA plan - $157 my plan = $192

Considering the wide range of services covered by the first $157, $192 seems like a pretty big jump in price to cover some cosmetic procedures.

Goes straight back to my main point - a large part of the $192 is a transfer payment from, a hidden tax on, an already struggling middle class.