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What's with the ads?

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Healthcare premiums to rise about 20%


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What's with the ads?

#151 ktgrok

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Posted 17 October 2017 - 11:45 AM

Listened to a bit about this on the radio today. An interesting aspect was one of marketing, which surprised me. Basically, you need younger, healthy people to get insurance to keep costs reasonable. But if it is hard to enroll, or they don't know how, they will just risk skipping insurance. Meanwhile the people with cancer or diabetes will do whatever they have to to sign up, even if it means hours on the phone on hold, whatever. So California spends a ton on marketing, and keeps open enrollment open longer, and in response they get more healthy people signed up, which lowers costs and keeps the insurance companies happy....which is one of the reasons they still have 11 plans to offer in that state versus what is happening in other places. If the insurance company knows only the very sick are likely to sign up they will cut their losses and run. 

 

Of course, we just decided to shorten enrollment periods, cut the marketing budget to 1/10 of what it was (and the marketing budget also goes to upgrading the sign up websites), take away payments to the insurance companies, stop enforcing penalties for not signing up, etc. Basically, everything possible to make sure only the very sick sign up. Sigh. 


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#152 arctic_bunny

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Posted 17 October 2017 - 05:15 PM

..... if one can't come up with the cost. They are amazed that we put up with it. Wondering if one should go to the ER or not due to cost? Unfathomable. Jars put out next to cashiers to assist with cancer (or other) treatments? Unheard of. Declaring bankruptcy due to too many medical bills from an illness or disease? Why do we put up with it as a nation....
.

Unfathomable, exactly. I had an annual physical, where the dr thought he felt something in my right breast. After my physical, the nurse in the office booked me in at the radiologist (completely different business, not affiliated with the office at all) and gave me a dtap booster. Radiology appointment made for 3 business days later. Full mammogram, with the pics sent to my dr while I waited about 3 minutes. He requested additional views and an ultrasound. I didn’t have an appointment for that, so had to wait about 30 minutes. Doctor will call me with the results either way in 2-3 days. Cost to me (that isn’t my tax dollars at work): $0

If we lived in the US, would I have even gone for an annual physical? What kind of choice would I have to make? I don’t know, maybe all that would have been covered?
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#153 Moxie

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Posted 17 October 2017 - 05:29 PM

Why is open enrollment a thing? I can buy life insurance, auto insurance, homeowners insurance, etc., any old time. No snark (well, mostly no snark) why do we have to get health insurance in this tiny window??
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#154 Arctic Mama

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Posted 17 October 2017 - 05:35 PM

Why is open enrollment a thing? I can buy life insurance, auto insurance, homeowners insurance, etc., any old time. No snark (well, mostly no snark) why do we have to get health insurance in this tiny window??


Because you can’t pressure people into a bad system without a credible threat like a fine, and you need a drop dead day to apply that sort of thing.

Also, since they had to compel people who didn’t want their crap product to buy it, and open enrollment allows for that but theoretically limits the amount of people picking up coverage just a day before using it for major medical, essentially. And since the fine is levied against tax refunds there needs to be clean fiscal timeframes for it.

Joy, right?
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#155 emzhengjiu

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Posted 17 October 2017 - 05:54 PM

In the "old" days of insurance,pre existing conditions were a great fear of mine. I'm praying we don't return to those days when I was afraid to see a doctor.



#156 kiana

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Posted 17 October 2017 - 05:59 PM

In the "old" days of insurance,pre existing conditions were a great fear of mine. I'm praying we don't return to those days when I was afraid to see a doctor.

 

Yes. I've recently started treatment for something that ... frankly, I would have avoided treatment for or getting diagnosed with if the pre-existing condition thing hadn't been nixed. I'm really scared to change jobs now. 


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#157 brehon

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Posted 17 October 2017 - 06:16 PM

Why is open enrollment a thing? I can buy life insurance, auto insurance, homeowners insurance, etc., any old time. No snark (well, mostly no snark) why do we have to get health insurance in this tiny window??


Open enrollment has been present in the marketplace for decades - long pre-dating the ACA.

Although I agree with you in principle that health insurance should be open like auto insurance, I think the fact that most health insurance in this country is still tied to employment is one one major reason why we have open enrollment periods. Employers simply can’t devote the time, money, or effort to constantly negotiate different plans with different insurance companies throughout the year. What a nightmare that would be.

I suppose the exchanges followed an already existing model. Most employees choose plans (in employer-based insurance) in the latter part of the fiscal year; so, I imagine the exchanges followed suit.
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#158 ChocolateReign

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Posted 17 October 2017 - 07:20 PM

Because you can’t pressure people into a bad system without a credible threat like a fine, and you need a drop dead day to apply that sort of thing.

Also, since they had to compel people who didn’t want their crap product to buy it, and open enrollment allows for that but theoretically limits the amount of people picking up coverage just a day before using it for major medical, essentially. And since the fine is levied against tax refunds there needs to be clean fiscal timeframes for it.

Joy, right?


So in your mind open enrollment periods didn’t exist before the ACA?

#159 ktgrok

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Posted 17 October 2017 - 07:21 PM

My understanding is that if you didn't have an enrollment period that was limited, people just wouldn't pay for it/enroll until they have a medical issue. 


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#160 TechWife

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Posted 17 October 2017 - 09:27 PM

If we lived in the US, would I have even gone for an annual physical? What kind of choice would I have to make? I don’t know, maybe all that would have been covered?

The annual physical and mammogram would both be free at the point of service under the ACA. The more detailed diagnostic mammograms might be covered differently and subject to a deductible, I'm not sure.
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#161 TechWife

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Posted 17 October 2017 - 09:32 PM

Why is open enrollment a thing? I can buy life insurance, auto insurance, homeowners insurance, etc., any old time. No snark (well, mostly no snark) why do we have to get health insurance in this tiny window??

To prevent people from only enrolling in insurance when they are sick. The risk pool needs both healthy and unhealthy people in order for the insurance to be affordable. That's also why the ACA initially had a requirement for everyone to have insurance. It's also why those who have national plans cover everyone.
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#162 kewb

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Posted 17 October 2017 - 09:47 PM

Because you can’t pressure people into a bad system without a credible threat like a fine, and you need a drop dead day to apply that sort of thing.

Also, since they had to compel people who didn’t want their crap product to buy it, and open enrollment allows for that but theoretically limits the amount of people picking up coverage just a day before using it for major medical, essentially. And since the fine is levied against tax refunds there needs to be clean fiscal timeframes for it.

Joy, right?

Open enrollment has always been a thing and has nothing to do with fines for not having insurance.
Probably has something to do with business budgets and taxes.
And to prevent people from buying insurance only when they are sick. Insurance works because people pay into it when they are healthy so you have it when you are sick.

Edited by kewb, 17 October 2017 - 09:51 PM.


#163 MaeFlowers

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Posted 17 October 2017 - 11:56 PM

Hospitals aren't going to knock that much off of a bill. By law, they cannot charge any patient lower than the Medicaid rate. Yes, I did see an itemized bill. I can't comment on charges for simple things such as Motrin and fluids because my son received none of that - all of his IV's (nine running simultaneously at one point) were either delivering medications or blood & blood products. Of course the hospital doesn't charge the true cost of service rendered. In our system, we cannot expect it to be so.


Hospitals can and do knock this much off a bill. I'm sure it probably varies by hospital system.

My dd was hospitalized in August. The amount billed was reduced by 70% because we are self pay. When she received care two years ago, they were using a sliding scale system. At that time, the bill was reduced by 85%.