Aetna Slowly Bailing out of ACA Public Health Insurance Exchange

[Murphy101]

Yeah. With my last baby, I was very sure of what was potentially legit and what was just bogus, and I still couldn't manage the situation because of being in labour. They were feeding me bogus stuff, but to get my thoughts together to oppose them or prevaricate was just not in the cards.

 

Afterward it occurred to me that I could easily have demanded to take it up to the next level of seniority, and that would likely have bought enough time that things would have sorted themselves out.

That's my go to tactic. Can we put this off? If we can, then it's not crisis enough to make a panic decision.

 

And I'm NOT anti-cesarean either. Which is another thing that is so blasted frustrating. The staff freaks out like I'm anti- c/s. No. There is zero doubt in my mind that I needed both of mine. I am anti- UNnecessary surgery in general. Once I think it is necessary? I'm all hurry the hell up and make the cut already. To the SURGICAL staff, a cesarean is no big deal and not wanting one is foolish drama seeking. They aren't the ones who take the health risk, have to recover while taking care of a newborn and life in general and go home with scar tissue.

 

And still, I wasn't in hospital or panicked, and most would consider me rather experienced, and I STILL was pressured to do that dadblum ultrasound I knew I didn't even need. Because contrary to what staff might think, I do happen to care considerably about making the best health decisions for myself and more importantly my child and so I did it against my better judgement bc they insisted so strongly how important it was to do it. Ugh. So ticked off, as much as myself as the staff.😣

[Lanny]

http://dailycaller.com/2015/12/11/many-obamacare-co-ops-are-leaving-patients-doctors-in-the-cold/

 

 

I havent been able to see one of my doctors in network for nine months, as his practice went bankrupt due to Health Republic's collapse and it took that long to reorganize and get a new agreement going with my ins.company.

 

Very interesting article. Everyone got screwed (policy holders. medical care providers and insurance brokers) and the Executives will probably retire to Grand Cayman. No accountability. Slush fund set up to benefit the Executives, like Solyndra?   Hopefully, there will be criminal investigations and some financial restitution to those that were not paid.

 

I hope you are now covered by a real insurance company and not a scam and that you can see your doctors.

[creekland]

My parents couldn't afford routine care, preventative, or diagnostic care when they were on a med share. Med share was major medical/hospitalization only so they had to pay out of pocket for everything nor related to a hospitalization. The many thousands this came to each year was more than they could afford at their income level. So often they let things like an upper repsiratory infection go so long that it morphed into bad pneumonia, then went to the ER and got admitted so that the ER visit, hospitalization, and 30 days od meds and follow up visits was covered. Over time this took a serious toll like my mom letting her blood sugar getting out of control so testing and meds would be covered due to the hospital stay which resulted in her begging for the docs to prescribe an entire year's worth of meds so she could have it filled immediately, and it would be covered. You can imagine what that did to her health.

 

They did this while I was a teen so I learned that no matter how sick I was, I could not speak up because the only healrhcare I could have was when I was bad enough to be in a dangerous state.

 

I cannot recommend these programs unless a person is going to save $10,000 or so a year dedicated to paying office calls, meds, and diagnostics.

 

Just reading this thread to kill time because we long ago left health insurance for Samaritan Ministries Health Share and are super glad we did.  The finances of insurance would have cost us a ton had we stuck with that (due to OOP limits and increased premium costs).

 

What you describe with your parent's plan is not what all of us have signed up for.  I haven't spent a single night in the hospital - nor have any of my kids or hubby - but health share has paid > $100,000 of our bills for everything from testing to see if something was wrong when hubby blacked out in our horse pasture to anything and everything with my brain tumor.

 

Yes, we pay for "basics" like annual visits or vaccs, but we also save at least 6K annually on cheaper monthly payments.  A lot of routine care can be purchased for that 6K.  We've never come close to meeting it.  My guess is your parents never saved their difference in cost vs premium to use on that.  That's what it's supposed to go toward - if needed.  One ought not "blame" health share for a bad set up in that case.

 

Then... we don't have to worry about networks or pre-approvals or things like that.  I could even need something overseas on our travels or with medical tourism and it would be fine.

 

I really like the Health Share System and was glad when those were accepted as ACA allowed.  We'd have been screwed if they weren't.  Ours does require Christian faith, etc, so they don't work for everyone, but the model is a darn good one if it could be copied IME.

 

No regrets here - and I often recommend them.  FAR less stress with better coverage all around.  They just don't work for everyone and our politicians won't let others organize to help cover everyone.

[Guest]

..

Edited August 24, 2016 by Heigh Ho

[TechWife]

Just reading this thread to kill time because we long ago left health insurance for Samaritan Ministries Health Share and are super glad we did.  The finances of insurance would have cost us a ton had we stuck with that (due to OOP limits and increased premium costs).

 

What you describe with your parent's plan is not what all of us have signed up for.  I haven't spent a single night in the hospital - nor have any of my kids or hubby - but health share has paid > $100,000 of our bills for everything from testing to see if something was wrong when hubby blacked out in our horse pasture to anything and everything with my brain tumor.

 

Yes, we pay for "basics" like annual visits or vaccs, but we also save at least 6K annually on cheaper monthly payments.  A lot of routine care can be purchased for that 6K.  We've never come close to meeting it.  My guess is your parents never saved their difference in cost vs premium to use on that.  That's what it's supposed to go toward - if needed.  One ought not "blame" health share for a bad set up in that case.

 

Then... we don't have to worry about networks or pre-approvals or things like that.  I could even need something overseas on our travels or with medical tourism and it would be fine.

 

I really like the Health Share System and was glad when those were accepted as ACA allowed.  We'd have been screwed if they weren't.  Ours does require Christian faith, etc, so they don't work for everyone, but the model is a darn good one if it could be copied IME.

 

No regrets here - and I often recommend them.  FAR less stress with better coverage all around.  They just don't work for everyone and our politicians won't let others organize to help cover everyone.

 

You are forgetting that Samaritan specifically and always excludes Type I Diabetes as a pre-existing condition, although they cover Type II Diabetes as a pre-existing condition if certain criteria are met. So, if the diabetes in question is Type I, her mother would have no hope of getting assistance through Samaritan Ministries. This means that she could miss treatment which could then cause further medical problems. So really, it is totally understandable how this happened. Diabetic care is only "basic" in that is it a "basic" need for life. "Basic" doesn't mean affordable when there is no insurance available. Even when there is insurance available, it doesn't mean that it is affordable for everyone. So yes, this is what you have signed up for. 

 

My son takes medication to help his kidney's process protein. Without this medication, his kidneys will sustain further damage and the end result could very well be need for a transplant. However, because my son cannot go without his medication for 12 months, nor would he be symptom free during that 12 months, Samaritan would not consider any expenses related to kidney disease to be "publishable." However, the US government would be glad to help out should he go into kidney failure. You see, at that point, he would qualify for Medicare, no matter what his age at the time. Government provided health care insurance would cover dialysis after the first three months, transplant costs and follow up care for three years. If he were to go into failure again after that, he would re-qualify. Copying the Samaritan Ministries Model could spell health and/or financial disaster for my son. So, no, it is not a model that should be copied. It is a model that works for very few people. 

 

ETA: Medicare does not require pre-approval, there are no monthly premiums for Part A (hospital) and there would be no need to go overseas for treatment as there isn't a reputable hospital around that doesn't participate in Medicare. The deductible is $1288 per hospitalization. After that, Medicare kicks in and pays 100% for 60 days of inpatient care. This is a bargain for a kidney transplant and many other types of care.

 

Since the idea of Samaritan Ministries is that it is Christians helping Christians, it's hard for me to swallow that this organization has so many exclusions - it really is Christians helping some Christians, but not all. In many cases, the US Government is more compassionate. 

 

I know I pipe in with these observations frequently, it is something I feel strongly about. My desire to show the downfalls of the program has taken on new meaning since my son was recently diagnosed with kidney disease. 

Edited August 23, 2016 by TechWife

[TechWife]

dp 

 

Edited August 23, 2016 by TechWife

[goldberry]

 

Yes, we pay for "basics" like annual visits or vaccs, but we also save at least 6K annually on cheaper monthly payments.  A lot of routine care can be purchased for that 6K.  We've never come close to meeting it.  My guess is your parents never saved their difference in cost vs premium to use on that.  That's what it's supposed to go toward - if needed.  One ought not "blame" health share for a bad set up in that case.

 

 

 

I've actually looked at share plans myself, so I'm not opposed, but the idea that everyone should be saving the difference in premiums implies that people could afford those higher premiums in the first place.  We can't.  That's why we are looking at the lower cost share plans.

 

We will still be able to afford preventative care, fortunately, but heck yeah, if I could afford $1000+/month premiums I would just be getting regular insurance.

[Frances]

Just reading this thread to kill time because we long ago left health insurance for Samaritan Ministries Health Share and are super glad we did. The finances of insurance would have cost us a ton had we stuck with that (due to OOP limits and increased premium costs).

 

What you describe with your parent's plan is not what all of us have signed up for. I haven't spent a single night in the hospital - nor have any of my kids or hubby - but health share has paid > $100,000 of our bills for everything from testing to see if something was wrong when hubby blacked out in our horse pasture to anything and everything with my brain tumor.

 

Yes, we pay for "basics" like annual visits or vaccs, but we also save at least 6K annually on cheaper monthly payments. A lot of routine care can be purchased for that 6K. We've never come close to meeting it. My guess is your parents never saved their difference in cost vs premium to use on that. That's what it's supposed to go toward - if needed. One ought not "blame" health share for a bad set up in that case.

 

Then... we don't have to worry about networks or pre-approvals or things like that. I could even need something overseas on our travels or with medical tourism and it would be fine.

 

I really like the Health Share System and was glad when those were accepted as ACA allowed. We'd have been screwed if they weren't. Ours does require Christian faith, etc, so they don't work for everyone, but the model is a darn good one if it could be copied IME.

 

No regrets here - and I often recommend them. FAR less stress with better coverage all around. They just don't work for everyone and our politicians won't let others organize to help cover everyone.

I'm not clear on how they could help everyone because in order to be financially viable and keep member costs low, they would have to exclude people with certain pre-existing conditions.

[creekland]

You are forgetting that Samaritan specifically and always excludes Type I Diabetes as a pre-existing condition, although they cover Type II Diabetes as a pre-existing condition if certain criteria are met. So, if the diabetes in question is Type I, her mother would have no hope of getting assistance through Samaritan Ministries. This means that she could miss treatment which could then cause further medical problems. So really, it is totally understandable how this happened. Diabetic care is only "basic" in that is it a "basic" need for life. "Basic" doesn't mean affordable when there is no insurance available. Even when there is insurance available, it doesn't mean that it is affordable for everyone. So yes, this is what you have signed up for. 

 

My son takes medication to help his kidney's process protein. Without this medication, his kidneys will sustain further damage and the end result could very well be need for a transplant. However, because my son cannot go without his medication for 12 months, nor would he be symptom free during that 12 months, Samaritan would not consider any expenses related to kidney disease to be "publishable." However, the US government would be glad to help out should he go into kidney failure. You see, at that point, he would qualify for Medicare, no matter what his age at the time. Government provided health care insurance would cover dialysis after the first three months, transplant costs and follow up care for three years. If he were to go into failure again after that, he would re-qualify. Copying the Samaritan Ministries Model could spell health and/or financial disaster for my son. So, no, it is not a model that should be copied. It is a model that works for very few people. 

 

ETA: Medicare does not require pre-approval, there are no monthly premiums for Part A (hospital) and there would be no need to go overseas for treatment as there isn't a reputable hospital around that doesn't participate in Medicare. The deductible is $1288 per hospitalization. After that, Medicare kicks in and pays 100% for 60 days of inpatient care. This is a bargain for a kidney transplant and many other types of care.

 

Since the idea of Samaritan Ministries is that it is Christians helping Christians, it's hard for me to swallow that this organization has so many exclusions - it really is Christians helping some Christians, but not all. In many cases, the US Government is more compassionate. 

 

I know I pipe in with these observations frequently, it is something I feel strongly about. My desire to show the downfalls of the program has taken on new meaning since my son was recently diagnosed with kidney disease. 

 

If your son was recently diagnosed with kidney disease, it'd have been covered, just as my son getting epilepsy when he was 16 was 100% covered.  If he was diagnosed prior to folks joining, that's where problems occur not because the Christian organization isn't Christian (as some like to imply), but because it's human nature for folks to not want to pay for anything until they need it and then join up afterward so someone else can help them pay.  Such a model would bankrupt the system quickly - just as insurances  have found they're now losing money because they can't exclude pre-exisiting conditions like they did before.

 

The full model I've mentioned in past threads would have everyone joining something similar to a health share - large groups covering what the individuals want covered, from hangnails to major medical (ours covers things in excess of $300 per incident - an amount that works well for us).  If folks want abortion covered (something SM does not), just join a group with similar minded folks.  Ditto that with smoking or drunkenness or routine visits or whatever.  How much one would have to pay monthly would depend upon the groups bills divided out.  No CEOs making millions.  No stockholders.  No profits to the organization.  No doctor offices dealing with insurance.  There's a bit of savings to be had when those are eliminated.

 

BUT, you're right.  Those with significant conditions require a bit more.  I think we all should chip into those.  I think once someone has passed, say, $500,000 of needs for an incident, they ought to get gov't paid medical care removing them (for that incident) from their program and seeing to it that no program goes bankrupt, but folks still get the care they need.  This would require less overhead for the gov't to worry about making it easier to run.  Taxes need to cover those.  Those are something I'd want my taxes paying for.

 

And for those who can't afford the basics?  I'd still keep Chip and similar helps for them - very much like WIC.  There are ways we can provide for all - if we (as a country) wanted to.

 

Scaring people off health share if it fits them can really hurt folks financially.  I'll explain more of our story below.

 

I've actually looked at share plans myself, so I'm not opposed, but the idea that everyone should be saving the difference in premiums implies that people could afford those higher premiums in the first place.  We can't.  That's why we are looking at the lower cost share plans.

 

We will still be able to afford preventative care, fortunately, but heck yeah, if I could afford $1000+/month premiums I would just be getting regular insurance.

 

I'd still go with health share.  It's miles better for those of us it works for.  We're covered at 100% with no network, no pre-approvals, & no hassle.  If we'd had insurance this past decade instead of health share we'd be out somewhere in the mid 5 digits financially.  Our OOP max would have been somewhere around $12,500 per year and we'd have hit that three times.  Then there's the $6,000 /year (minimum) difference in premiums.  We only use a fraction of that on routine care.  We haven't come close to breaking even on that part, much less making insurance less expensive.

 

I shudder to think of where I'd have been if we'd opted to stick with insurance.

 

There have been other ladies at school who have had serious medical problems - "covered" by the school insurance.  We've had fundraisers for them to help cover costs.  They asked me if we had similar needs.  No.  With 100% coverage, no we haven't.

 

YMMV

[creekland]

Rereading my post and looking at my own math... we'd be out closer to six digits financially over the decade.  Just the OOP max puts us close to 40K, then the 6K differences in premiums, lower that to 5K because we did do some routine care, but over a decade, brings that up to 50K.  Then our insurance on non OOP max years only paid 80% once we hit our 1 or 2K deductible and we had some incidences like my son breaking his collar bone and hubby's blacking out in the horse pasture that happened in non maxed out years.  We'd be out somewhere in the neighborhood of 100K comparatively.

 

Yes, I shudder when I think about what could have happened!

[TechWife]

If your son was recently diagnosed with kidney disease, it'd have been covered, just as my son getting epilepsy when he was 16 was 100% covered.  If he was diagnosed prior to folks joining, that's where problems occur not because the Christian organization isn't Christian (as some like to imply), but because it's human nature for folks to not want to pay for anything until they need it and then join up afterward so someone else can help them pay.  Such a model would bankrupt the system quickly - just as insurances  have found they're now losing money because they can't exclude pre-exisiting conditions like they did before.

 

 

Just to be clear, It is a Christian organization that is making financial stability a priority over taking care of fellow believers. It is a no win situation when it comes to expensive treatments and so it truly does operate in a manner similar to insurance. The only difference now is that cost shares are still free to discriminate. 

 

I know a few people who participate in cost shares and they are adamant that it is because of the duty Christians have to take care of one another. With this in mind, I find it fascinating that you are proposing that the government be responsible for the most expensive treatments. You've succeeded in boggling my mind today! 

[JumpyTheFrog]

We had Samaritan for about seven years. I grew increasingly uncomfortable with the extreme theology they pushed in their newsletters. What really made me lose respect for them was when they published a Special Prayer Need (an opportunity for members to support medical care not covered under the plan) for anorexia. It said treatment for anorexia wasn't covered because it was considered psychiatric and all psych care is excluded. I already knew psych care was excluded, but not covering anorexia really bothered me.

[creekland]

Just to be clear, It is a Christian organization that is making financial stability a priority over taking care of fellow believers. It is a no win situation when it comes to expensive treatments and so it truly does operate in a manner similar to insurance. The only difference now is that cost shares are still free to discriminate. 

 

I know a few people who participate in cost shares and they are adamant that it is because of the duty Christians have to take care of one another. With this in mind, I find it fascinating that you are proposing that the government be responsible for the most expensive treatments. You've succeeded in boggling my mind today! 

 

If financial stability were not a factor, how could they continue helping anyone?  Is that somehow better?

 

As a Christian (human), I feel it's my duty to care for anyone (Christian or not - sharing any of my views or not).  Living on the Canadian/US border for a good part of my life and having a Canadian step mom has helped me see the pros and cons of both of our systems.  Having a German exchange student whose father was a doctor in Germany helped me see more of a European model - with its pros and cons too.  My "goal" for my "ideal world" is to figure out a program that would work the best for all.

 

Sorry if that boggles your mind.  Looking at things "outside the box" of what is expected (when expected doesn't work the greatest) is part of what I like to do.  I'm fully aware of how difficult it is to get others to see anything outside the lines drawn.  Perhaps that's why I like working with teens the best.  They aren't yet confined by lines...

[creekland]

Just to be clear, It is a Christian organization that is making financial stability a priority over taking care of fellow believers.  

 

Are all Christian organizations supposed to go bankrupt because they want to help the whole world, but can't?  Or just health shares?

 

ETA:  Can I also presume you're not doing well financially since there are so many worthy causes we need to be sending ALL our money to?  (Or perhaps you're not Christian, so are exempt.  I honestly don't pay attention to who is and who isn't on this board.  If not, then are only Christians supposed to spend themselves into the poorhouse due to all the worthy causes our planet has?)

Edited August 23, 2016 by creekland

[Guest]

..

Edited August 24, 2016 by Heigh Ho

[mommytobees]

 

Since the idea of Samaritan Ministries is that it is Christians helping Christians, it's hard for me to swallow that this organization has so many exclusions - it really is Christians helping some Christians, but not all. In many cases, the US Government is more compassionate. 

 

I know I pipe in with these observations frequently, it is something I feel strongly about. My desire to show the downfalls of the program has taken on new meaning since my son was recently diagnosed with kidney disease. 

 

I agree.

 

I've been trying to figure out my DS18's future medical healthcare coverage.

 

I've contacted dozens of different companies and agencies, including Samaritan. Samaritan was almost insulting. It is healthy Christians covering other healthy Christians who might run into a health crisis. 

 

Kris

[Guest]

Ethically, I cant agree with the denial of coverage for things that arent lifestyle choices. A young person with myopia so severe that they cant see the E on the eye chart could easily and cheaply have that corrected so they could see and have no restrictions on their employability. Dental. Numerous other examples of genetic issues that are on the refuse to cure list. Penny wise, pound foolish and it reeks of a decision to actively eliminate the 'defective' people rather than compassionately help people overcome random genetic defects.

Edited August 23, 2016 by Heigh Ho

[Bluegoat]

True. I often say the role of the doula is mainly to say "would you like time to think about that?" to remind the mom she CAN take time to think about it. In private. But not all doulas are good at speaking up like that, and not everyone can afford one. 

 

I had a doula, who was very good, and helpful as she could be, but the situation was rather more pressurized than just thinking about it.  Doulas walk a bit of a line, they can be ejected from the room if the staff decides they are causing a problem, and they can't really go so far as to argue in the place of the patient.

[Murphy101]

Ethically, I cant agree with the denial of coverage for things that arent lifestyle choices. A young person with myopia so severe that they cant see the E on the eye chart could easily and cheaply have that corrected so they could see and have no restrictions on their employability. Dental. Numerous other examples of genetic issues that are on the refuse to cure list. Penny wise, pound foolish and it reeks of a desire to eliminate the 'defective' rather than compassionately help people overcome random genetic defects.

Ack. Who the heck is for that?

 

And yeah, I think there's a lot of penny wise, pound foolish in medicine in general today.

 

I think some of it stems from the misconception that sickness or defect is something to be avoided rather than an inevitable to be dealt with. Diabetes is something to control. Except it isn't exactly bc it is also a disease, and most disease is not entirely controllable. Dental is another. Just brush and go to the dentist for cleanings. Except not everyone is born with the good teeth Gene and no amount of brushing and dental check ups are going to change that their teeth are just weaker and far more inclined to problems.

 

We can avoid a lot with healthy lifestyles, but let's get real. Our society is not set up to provide or even encourage a healthy lifestyle for a huge number of our population. We are fine blaming them, while completely ignoring that almost nothing in our society is set up to give them healthier choices whether they want them or not.

[Bluegoat]

That's my go to tactic. Can we put this off? If we can, then it's not crisis enough to make a panic decision.

 

And I'm NOT anti-cesarean either. Which is another thing that is so blasted frustrating. The staff freaks out like I'm anti- c/s. No. There is zero doubt in my mind that I needed both of mine. I am anti- UNnecessary surgery in general. Once I think it is necessary? I'm all hurry the hell up and make the cut already. To the SURGICAL staff, a cesarean is no big deal and not wanting one is foolish drama seeking. They aren't the ones who take the health risk, have to recover while taking care of a newborn and life in general and go home with scar tissue.

 

And still, I wasn't in hospital or panicked, and most would consider me rather experienced, and I STILL was pressured to do that dadblum ultrasound I knew I didn't even need. Because contrary to what staff might think, I do happen to care considerably about making the best health decisions for myself and more importantly my child and so I did it against my better judgement bc they insisted so strongly how important it was to do it. Ugh. So ticked off, as much as myself as the staff.😣

 

Yes, this is just how I feel - I am not at all anti-modern medicine.  Some would say I am much closer to being anti-alternative medacine, because there is some of that which is franly quakery and I think there is an actual need for evidence there as well.  I don't mind doing tests for good reasons, or even sometimes if they are easy for less serious ones.  I wasn't planning this time to do the glucose screening, but I did just because I had to go for another test anyway.

 

But when they aren't consistant as in your example, it makes it hard to take their advice seriously, and they should be the people that can give some expert/experienced advice. 

[TranquilMind]

When you make your sales pitch, you really need to mention the restrictions on annual claims that are allowed. It wont cover people that become very ill...they will need to have other means to pay.

 

As far a total costs, a decade ago my health share costs were reasonable. The AFA changed that, raising the oop max sky high. My $150k in treatment five years ago didnt even cost me $500 oop...today under AFA I would have paid $16K each year for 2 years plus the followups would cost me 3000 in deductibles annually plus about 2k in cost sharing for bloodwork and scans on top of the annual premium. And none of this was a lifestyle choice. It appears to be a result of the govt putting folic acid into the food supply and prenatals that harm the 40% of people with my genetics....but no one will admit that, for obvious reasons.

That's eye opening.

 

My husband noted thatif my appendix had to burst,  it was preferable that it did so before the end of the year where we changed over to the (more) awful insurance.  It cost us $6K out of pocket and would have been about $25K the next year. 

Edited August 23, 2016 by TranquilMind

[Lady Florida.]

I agree.

 

I've been trying to figure out my DS18's future medical healthcare coverage.

 

 

 

It's going to be tough for both ds and me if dh sticks to his plan to retire in two years. He'll be eligible for Medicare but I won't. Ds 18 is currently on dhs' work plan and will still be in college when dh retires (so not working a full time job that provides insurance). I hate to tell dh he should keep working, but I don't know what we'll do for insurance. 

[Bluegoat]

Regarding things like health shares, and speaking generally - while it may not be that the set-up is ideal, even from a moral theology perspective, I think that is largely or in part becase they are forced to work within a particular framwork that is simply an inadaquate way to find healthcare.  It isn't necessarily possible, within that, to create something better for health coverage.

 

Under those circumstances, I don't think it's wrong to go ahead with the imperfect solution, though it ought to be accompanied by some kind of effort to change the systematic problem, and if possible help to cover the inadaquacy in some other way.

[creekland]

When you make your sales pitch, you really need to mention the restrictions on annual claims that are allowed. It wont cover people that become very ill...they will need to have other means to pay.

 

Are you meaning heath share with this?  I can't tell.  If so, then it depends totally upon which coverage one wants (with Samaritans, I haven't looked into the others).  We have no limit.

[creekland]

Regarding things like health shares, and speaking generally - while it may not be that the set-up is ideal, even from a moral theology perspective, I think that is largely or in part becase they are forced to work within a particular framwork that is simply an inadaquate way to find healthcare.  It isn't necessarily possible, within that, to create something better for health coverage.

 

Under those circumstances, I don't think it's wrong to go ahead with the imperfect solution, though it ought to be accompanied by some kind of effort to change the systematic problem, and if possible help to cover the inadaquacy in some other way.

 

I have yet to find a "perfect" system - in our country or others.  

 

Everyone needs to look at all options available to them and make their choice.  What's the "best" imperfect system for them.  The only thing I never recommend is going without something.  That's way too risky IME.

 

And as humans, we ought to continue to look for ways to assist others.

 

Hoppy points out an imperfection with Samaritans in an earlier post.  I like the fact that they publish those in a special section so those of us who want to support such situations can.  I know I've donated a fair bit above and beyond our monthly share to similar situations because I wish they were covered.  I also know guidelines get revised each year - and more coverage is being added each year - something I'm pleased with.

 

Then I know those I eat lunch with at school - other people who have school insurance.  I've seen one mom & dad empty their retirement account to get counseling for their teen daughter with an eating and mental disorder.  There wasn't much "coverage" for them either.  What was covered was so limited it would easily have fit into our 6K per year of "routine" allowances.

 

Another mom & dad had to mortgage their house to get treatment for their son who developed a substance abuse issue.  That also is not covered by SM, but again, what little was covered by insurance didn't seem to make much of a difference.

 

If any school employee wants vision or dental, that's extra they pay for (most of the rest is included with their salary, so no need to switch financially).

 

Our country doesn't have great options when it comes to these sorts of things.  It's frustrating TBH.  What does Canada do?

[creekland]

It doesn't boggle my mind, but it is a puzzling view. It's a select group of Christians deciding which select group of other Christians will be covered. Isn't this the kind of crap we tried to solve with the ACA, to get as many people as we can insured?( yes, it hasn't been a big success, but...) yet you propose having the gov't pay for $500,000+ bills?

And then you make the comment that you enjoy teens, because their minds aren't confined by lines? Is that a roundabout way of saying the PP is closed minded? That says quite a lot. YMMV

 

Is there any reason the gov't shouldn't cover big bills (for anyone needing it) and allow multiple groups to band together as they like to cover smaller things?

 

And yes... I find many who are past their teen years to be set in their ways/thoughts - all sorts of subjects.  I also see it on this board a lot (many threads).  People can gauge for themselves if it applies to them or not.  

[Bluegoat]

I have yet to find a "perfect" system - in our country or others.  

 

Everyone needs to look at all options available to them and make their choice.  What's the "best" imperfect system for them.  The only thing I never recommend is going without something.  That's way too risky IME.

 

And as humans, we ought to continue to look for ways to assist others.

 

Hoppy points out an imperfection with Samaritans in an earlier post.  I like the fact that they publish those in a special section so those of us who want to support such situations can.  I know I've donated a fair bit above and beyond our monthly share to similar situations because I wish they were covered.  I also know guidelines get revised each year - and more coverage is being added each year - something I'm pleased with.

 

Then I know those I eat lunch with at school - other people who have school insurance.  I've seen one mom & dad empty their retirement account to get counseling for their teen daughter with an eating and mental disorder.  There wasn't much "coverage" for them either.  What was covered was so limited it would easily have fit into our 6K per year of "routine" allowances.

 

Another mom & dad had to mortgage their house to get treatment for their son who developed a substance abuse issue.  That also is not covered by SM, but again, what little was covered by insurance didn't seem to make much of a difference.

 

If any school employee wants vision or dental, that's extra they pay for (most of the rest is included with their salary, so no need to switch financially).

 

Our country doesn't have great options when it comes to these sorts of things.  It's frustrating TBH.  What does Canada do?

 

In terms of options?

 

Well, it isn't precisely the same in each province, but there are some general similarities.  THe provincial insurer in each province covers most of the medical fees that are considered basic - there are requirements they have to meet at the federal level.  That doesn't always mean that everything that people need/want is covered though or that illness can't create costs.  But there may be differences - like in Ontario people get both a psychiatrist and psychologist, but in NS only the former is covered.

 

One thing that is odd is that unlike other countries with universal care, we don't include drugs in that, except for the poor and seniors.  So - most people have a drug plan or pay out of pocket.  Often it may be an employee benefit or people get a private plan.  (Doctors tend to be very conscious and helpful with it in my experience, many will stockpile samples for people who have to pay out of pocket for expensive drugs.)  These plans also tend to cover some things that aren't covered by the province or where people may pay privately if they choose, like massage or physio.

 

(I suspect we'll see a universal drug program in the future, the Green Party here was pushing it and it was picked up by the Liberals which means it could actually be created if they really wanted to.  It would save the country quite a bundle of money if they had one so there is really no good reason not to.)

 

There are also other programs that can help with some costs, like the disability tax benefit, or people who are off work for being sick are entitled to various kinds of income supplements/replacements, tax breaks on equipment like wheelchairs or ramps, cost of travel, and so on.  There are also charitable organizations that help with some of these things. 

 

Some of the trickiest stuff is in mental health and addictions, though that is not necessarily because it isn't covered directly.  Someone hospitalized would be, but often specialized programs are run by special organizations, that may not be funded as well as they might or funding gets cut when it isn't shiny and new looking for a new government or something.  Or sometimes there can just be a hard time finding some kinds of staff and so people have to look farther afield.

[Frances]

Is there any reason the gov't shouldn't cover big bills (for anyone needing it) and allow multiple groups to band together as they like to cover smaller things?

 

And yes... I find many who are past their teen years to be set in their ways/thoughts - all sorts of subjects. I also see it on this board a lot (many threads). People can gauge for themselves if it applies to them or not.

The problem I with having the government step in to help only for big things is that it would likely lead to the same types of problems we currently have with Medicaid. Since only some people will ever benefit from it, many will not want to support it financially or politically, and the people needing it will suffer. Medicare is generally thought to be a much better program because ultimately everyone will benefit, and therefore it has much stronger political support. Unfortunately, we do not remotely have a view that we are all in it together in the US, as many countries with universal healthcare do.

 

Edited to add that I also think people with certain pre-existing conditions would be unable to find any group to take them and would be left with nothing except the problematic coverage for big stuff.

Edited August 23, 2016 by Frances

[creekland]

The problem I with having the government step in to help only for big things is that it would likely lead to the same types of problems we currently have with Medicaid. Since only some people will ever benefit from it, many will not want to support it financially or politically, and the people needing it will suffer. Medicare is generally thought to be a much better program because ultimately everyone will benefit, and therefore it has much stronger political support. Unfortunately, we do not remotely have a view that we are all in it together in the US, as many countries with universal healthcare do.

 

Edited to add that I also think people with certain pre-existing conditions would be unable to find any group to take them and would be left with nothing except the problematic coverage for big stuff.

 

Yeah, getting something like my thoughts passed would take a lot of people being willing to think outside the current lines AND no influence from our current for-profit insurance groups who make millions.

 

But someone can still have a pipe dream and I enjoy discussing about potential "workable" options with those willing to actually discuss (as you are doing).

 

I think you're right with the pre-existing, but that would only happen during the changeover, so the gov't would have to cover those too - probably with people paying a similar amount in to assist with costs as they would be if they joined a group.  Once folks choose where they fit in, their kids would be in that group just as mine are covered by SM for as long as they remain members.

 

I also think we'd need a clause that says once someone is in a group, they can change to a similar group if needed without penalty.  For groups arranged around a cause (like Christians or motorcycle riders or teachers or...) if someone changes, they'll need to (and probably prefer to) belong elsewhere, esp if they want different things covered for themselves (as teens+).

 

There's a bit of ironing out - just as with any option on the table.

 

For now though, I think it's important that we (Americans) suggest any option that seems to fit a person rather than condemning options because they don't fit "us."  The goal is everyone gets something affordable with what we have - while we also work to get a better system.

 

If it came to a vote, I'd definitely go single payer over what our country has now, but I think there can be better options as my health share works better than my step mom's Canadian coverage and even our German exchange student's family bought private insurance to have better coverage than what Germany offered.  (This was in '99-'00, so could have changed - we haven't discussed it since that year - though she was understandably concerned when she found out about the brain tumor, then relieved when it was fine both physically and cost-wise.)

 

And with single payer similar to Canada or others, I'd probably still top up TBH.  It's good, but not perfect.  It's just better IMO than what our country currently has.  Our country leaves too many behind and/or bankrupts others.

[ktgrok]

 

 

If it came to a vote, I'd definitely go single payer over what our country has now, but I think there can be better options as my health share works better than my step mom's Canadian coverage and even our German exchange student's family bought private insurance to have better coverage than what Germany offered. 

 

Yes, but it works better (or rather, cheaper) mainly because it only has to cover people who aren't very sick. If you expand it to everyone, that wouldn't work. Wheneve you look at something that covers everyone, some people will have to accept a bit less in order for others, who now don't have enough, to get more. 

[creekland]

Yes, but it works better (or rather, cheaper) mainly because it only has to cover people who aren't very sick. If you expand it to everyone, that wouldn't work. Wheneve you look at something that covers everyone, some people will have to accept a bit less in order for others, who now don't have enough, to get more. 

 

Which is why I mentioned that I think it's best if the gov't covered the very sick - with everyone paying into it via taxes. No "group" would suffer.  Other bills could still be shared and covered. (Statistically, this works.  SM has even covered organ transplants without an economic impact on the rest of us.)

 

Someone earlier said 5% of people use the most health care money.  If that's true, the other 95% could be covered very nicely.  Ok, maybe 75% if we also take out the truly low income who can't afford anything.

 

Taking out the profit - and the cost of large amounts of gov't oversight and potential red tape - could end up making the whole thing far more affordable.  Not having networks is also a HUGE plus that I love.

[ktgrok]

Which is why I mentioned that I think it's best if the gov't covered the very sick - with everyone paying into it via taxes. No "group" would suffer.  Other bills could still be shared and covered. (Statistically, this works.  SM has even covered organ transplants without an economic impact on the rest of us.)

 

Someone earlier said 5% of people use the most health care money.  If that's true, the other 95% could be covered very nicely.  Ok, maybe 75% if we also take out the truly low income who can't afford anything.

 

Taking out the profit - and the cost of large amounts of gov't oversight and potential red tape - could end up making the whole thing far more affordable.  Not having networks is also a HUGE plus that I love.

 I guess I'm not seeing why that makes more sense than having the government cover 100 percent of the people. I mean, otherwise you have someone on a healthshare that gets too sick, or has something not covered, or whatever, and they now have to apply for the government program, etc. Easier to have everyone in one program, right?

 

edited to add: It's also not just the sickest that can't do a healthshare. It' the poorest, who either can't afford the healthshare monthly cost, or can, but then can't afford the preventative care that a health share doesn't cover. So they too would need government help or would be out of luck. At that point, much simpler to have everyone on the same plan from the beginning. 

Edited August 23, 2016 by ktgrok

[creekland]

 I guess I'm not seeing why that makes more sense than having the government cover 100 percent of the people. I mean, otherwise you have someone on a healthshare that gets too sick, or has something not covered, or whatever, and they now have to apply for the government program, etc. Easier to have everyone in one program, right?

 

edited to add: It's also not just the sickest that can't do a healthshare. It' the poorest, who either can't afford the healthshare monthly cost, or can, but then can't afford the preventative care that a health share doesn't cover. So they too would need government help or would be out of luck. At that point, much simpler to have everyone on the same plan from the beginning. 

 

Because I also have an uncle (veteran) who has to deal with our VA system.  Like Canada (from IRL examples with my step mom), I just don't see where the gov't does a great job either.  I think those outside the gov't can do better for the majority of the people - when health care insurance/coverage is NOT for profit.

 

I addressed the poor in my post that you quoted.  Yes, they would need to stick with gov't programs.  As others have attested, sometimes those are decent and sometimes not.  Nothing is perfect for everyone's needs.

[mommytobees]

Because I also have an uncle (veteran) who has to deal with our VA system.  Like Canada (from IRL examples with my step mom), I just don't see where the gov't does a great job either.  I think those outside the gov't can do better for the majority of the people - when health care insurance/coverage is NOT for profit.

 

I addressed the poor in my post that you quoted.  Yes, they would need to stick with gov't programs.  As others have attested, sometimes those are decent and sometimes not.  Nothing is perfect for everyone's needs.

 

There is a huge difference between the VHA, Medicaid, Medicare, Tricare/Champus, SCHIP (federal state children's programs), and the IHS (Indian Health Services) systems. Huge! The VHA has been having loads of problems, for multiple reasons/excuses. However, you do not see those same problems happening in any of the other areas.

 

Are there problems? Yes! Absolutely. I have a heck of a time with UHC, who currently services Tricare West region and am filed a formal complaint today for a change in management and failure to notify their members. I know many people in IHS who have complaints. And so on...

 

However, when we get to the nitty gritty of the problems: VHA has issues that none of the other groups do.

 

 

One out of six federally funded and run health care programs have serious problems. How is that the government doing a subpar job?

 

Kris

[bethben]

 

 

Since the idea of Samaritan Ministries is that it is Christians helping Christians, it's hard for me to swallow that this organization has so many exclusions - it really is Christians helping some Christians, but not all. In many cases, the US Government is more compassionate. 

 

I know I pipe in with these observations frequently, it is something I feel strongly about. My desire to show the downfalls of the program has taken on new meaning since my son was recently diagnosed with kidney disease. 

 

It also doesn't cover my special needs son at all (he has a chromosome problem) nor my adopted daughter with her cleft lip/palate issues.  I hear you on this issue.  I understand that the company could easily go bankrupt having to provide care for kids like these, but then again, the most vulnerable in our society are not covered by their company.  

[Murphy101]

The problem I with having the government step in to help only for big things is that it would likely lead to the same types of problems we currently have with Medicaid. Since only some people will ever benefit from it, many will not want to support it financially or politically, and the people needing it will suffer. Medicare is generally thought to be a much better program because ultimately everyone will benefit, and therefore it has much stronger political support. Unfortunately, we do not remotely have a view that we are all in it together in the US, as many countries with universal healthcare do.

 

Edited to add that I also think people with certain pre-existing conditions would be unable to find any group to take them and would be left with nothing except the problematic coverage for big stuff.

It doesn't HAVE to be like that though. Instead of when something big happens they apply for it, everyone is automaticly on it should something big happen.

 

And I'm not all in for Medicare either. A whole lot of people never benefit from it. That's the financial edge there. A lot of people die before they get to use it. That's also why they keep raising the age to qualify for it. To reduce who gets to use it, or at least how long they get to.

[TechWife]

It doesn't HAVE to be like that though. Instead of when something big happens they apply for it, everyone is automaticly on it should something big happen.

 

And I'm not all in for Medicare either. A whole lot of people never benefit from it. That's the financial edge there. A lot of people die before they get to use it. That's also why they keep raising the age to qualify for it. To reduce who gets to use it, or at least how long they get to.

 

The number of people who live long enough to use Medicare is steadily increasing. By 2050, the number in the over 65 age group will have doubled since 2012. That's only 38 years. Currently, one has to be 67 to become eligible for Medicare. The life expectancy of someone who was 65 years old in 2012 is an additional 20 years for males and 23 years for females. That means people who were 65 in 2012 will live to be 85-88 years old, respectively. That's a lot of years to be covered by Medicare. 

[TechWife]

That's eye opening.

 

My husband noted thatif my appendix had to burst,  it was preferable that it did so before the end of the year where we changed over to the (more) awful insurance.  It cost us $6K out of pocket and would have been about $25K the next year. 

 

That's a hideous difference! I am so sorry. 

 

My son was hospitalized on Dec. 31 a few years ago. Two deductibles in two days! Two out of pocket maximums in two days. Untangling what went with what year was confusing. In case anyone is wondering, the hospital charges went to 2013 because the admit date was in 2013, but medication, equipment, lab, radiology and surgical charges all went to 2014 because they were charged out on the service date. 

[TranquilMind]

That's a hideous difference! I am so sorry.

 

My son was hospitalized on Dec. 31 a few years ago. Two deductibles in two days! Two out of pocket maximums in two days. Untangling what went with what year was confusing. In case anyone is wondering, the hospital charges went to 2013 because the admit date was in 2013, but medication, equipment, lab, radiology and surgical charges all went to 2014 because they were charged out on the service date.

Wow! That's awful. I hope he got well quickly. But what a crazy system.

[Catalytic]

Many of us have to keep the expired ones and hope they still work in an emergency. That's what I'm doing. My epipen is long expired but the fluid is still clear, so fingers crossed it will work. My shellfish reactions seem to worsen drastically every time I have one. If that holds true, I'm going to need it next time.

 

 

Mergath, could you PM me?  Tried to PM you and it won't go through.

 

This Epipen fiasco is ludicrous.  Was glad to read about the gov't looking into this earlier this week.  (What improvements?)

[Lanny]

Mergath, could you PM me?  Tried to PM you and it won't go through.

 

This Epipen fiasco is ludicrous.  Was glad to read about the gov't looking into this earlier this week.  (What improvements?)

 

Possibly this article about EpiPen will be of interest to you:

 

http://www.foxbusiness.com/markets/2016/08/24/epipen-price-gouging-came-as-mylan-pulled-off-tax-inversion.html

[Mergath]

Mergath, could you PM me?  Tried to PM you and it won't go through.

 

This Epipen fiasco is ludicrous.  Was glad to read about the gov't looking into this earlier this week.  (What improvements?)

 

PM sent! :)

[NoPlaceLikeHome]

Are you meaning heath share with this?  I can't tell.  If so, then it depends totally upon which coverage one wants (with Samaritans, I haven't looked into the others).  We have no limit.

Yes but ultimately there is no guarantee of coverage since Samaritan is not insurance. What will Samaritan do if multiple members have medical catastrophes at the same time that is beyond their ability to offer coverage?

 

IMHO the solution is universal single payer healthcare for all.

[creekland]

Yes but ultimately there is no guarantee of coverage since Samaritan is not insurance. What will Samaritan do if multiple members have medical catastrophes at the same time that is beyond their ability to offer coverage?

 

Feel free to worry about the improbable if you wish.  I'm still quite thankful for the 100K in savings we've had over the past decade compared to if we'd been with "guaranteed" insurance with the medical issues that hit our family.  50K of it came simply from the lower cost even if we hadn't had a single issue.  I don't care to toss that much away personally - or hand it over to stockholders or CEOs earning millions.  Then too, I'm pretty partial to not needing to worry about networks, but that's secondary.  The cost difference makes me incredibly glad we took the "risk."

 

YMMV  

[Ravin]

Actually, they don't have a responsibility to shareholders to maximize their profits. Run the company responsibly? Yes, that is one thing they are supposed to do. However, being responsible does not mean that they must maximize profits. That is an economic idea, not a legal one. Legally, shareholders have limited legal rights. They only have a right to company profits via dividends if the board of the company chooses to issue dividends. Boards are not obligated to do so and when they do, they choose how much they want to issue. Shareholders have the right to: sell their shares (they do not have a right to make a profit when they do so), vote for board officers, get some information about the company and a very limited right to sue the company for breach of fiduciary duties.

The Fundamental Rights of the Shareholder

 

 

The Dumbest Business Idea Ever: The Myth of Maximizing Shareholder Value

 

 

 

The Toxic Side Effects of Shareholder Primacy

 

 

 

The Toxic Side Effects of Shareholder Primacy

 

Maximizing shareholder value in the short term can damage the corporation's value in the long term.

 

 

 

The Toxic Side Effects of Shareholder Primacy

 

 

 

The Toxic Side Effects of Shareholder Primacy

Look up Dodge v. Ford Motor Co.

[ktgrok]

Feel free to worry about the improbable if you wish.  I'm still quite thankful for the 100K in savings we've had over the past decade compared to if we'd been with "guaranteed" insurance with the medical issues that hit our family.  50K of it came simply from the lower cost even if we hadn't had a single issue.  I don't care to toss that much away personally - or hand it over to stockholders or CEOs earning millions.  Then too, I'm pretty partial to not needing to worry about networks, but that's secondary.  The cost difference makes me incredibly glad we took the "risk."

 

YMMV  

 

Well yes, the risk worked out for you. And yes, the worst case is improbable, but that's kind of the whole point of insurance, to let you stop worrying about the improbable because it covers you. If the risk hadn't worked out, you'd have a different story. I know people with zero insurance, no health share, nothing, and because they haven't had a medical issue they say the risk worked out for them. That doesn't mean it is a risk worth taking. Now, I will agree you have lower risk than them, significantly, but there is a risk. 

Edited August 25, 2016 by ktgrok

[creekland]

Well yes, the risk worked out for you. And yes, the worst case is improbable, but that's kind of the whole point of insurance, to let you stop worrying about the improbable because it covers you. If the risk hadn't worked out, you'd have a different story. I know people with zero insurance, no health share, nothing, and because they haven't had a medical issue they say the risk worked out for them. 

 

That's comparing apples to oranges if they haven't had a medical issue (or multiple issues like we've had).  I'm comparing insurance to health share, and obviously, I don't see it as a risk that we won't get our needs covered.  We've had too much IRL experience to worry about it TBH.  Others are welcome to their own thoughts and/or worries.

 

If we'd gone without insurance or health share then we'd be out more than 100K - IF we could have paid for treatment as not all of what was done would have been done.  Considering NONE of our needs were based upon diet or exercise or smoking or anything "preventable," I definitely see "going without" to be super risky - a real risk.  I never recommend that to anyone personally.

[mommytobees]

 

If we'd gone without insurance or health share then we'd be out more than 100K - IF we could have paid for treatment as not all of what was done would have been done.  Considering NONE of our needs were based upon diet or exercise or smoking or anything "preventable," I definitely see "going without" to be super risky - a real risk.  I never recommend that to anyone personally.

 

But this isn't solely about someone going without. This is about the next step as well. This is about how we live our lives. Anyone who lives their life with no health insurance is taking a huge risk, but so are the people who rely on their current health insurance plan, that includes cost share programs like Sam.

 

What happens if/when the Impossible or Improbable happens?

What happens if you run out of money?

What happens if you are unable to make your insurance payments?

 

The Impossible happened to my family. Last year, my 17yo son was dx'ed with a very rare form of MS. The CDC lists it at 3 in 1,000,000 and only 10% of those individuals are dx'ed under the age of 20. His current health insurance is through his father, who is AD Navy. However, his dad can drop him at any time. I cannot provide him with health insurance right now, as I'm a full-time student. 

 

He must have insurance. His medications and vitamins cost OOP $65 per month, plus his DMT MS drug is $2100 per month pre-insurance. That is just maintenance. Any relapse and we are talking at minimum several thousand for in-home steroid therapy. Add in additional costs: PT, MRI's of brain and spine (he has 4 lesions on his spine), and what not.

 

What happens in the future?

 

Kris

[Catalytic]

But this isn't solely about someone going without. This is about the next step as well. This is about how we live our lives. Anyone who lives their life with no health insurance is taking a huge risk, but so are the people who rely on their current health insurance plan, that includes cost share programs like Sam.

 

What happens if/when the Impossible or Improbable happens?

What happens if you run out of money?

What happens if you are unable to make your insurance payments?

 

The Impossible happened to my family. Last year, my 17yo son was dx'ed with a very rare form of MS. The CDC lists it at 3 in 1,000,000 and only 10% of those individuals are dx'ed under the age of 20. His current health insurance is through his father, who is AD Navy. However, his dad can drop him at any time. I cannot provide him with health insurance right now, as I'm a full-time student. 

 

He must have insurance. His medications and vitamins cost OOP $65 per month, plus his DMT MS drug is $2100 per month pre-insurance. That is just maintenance. Any relapse and we are talking at minimum several thousand for in-home steroid therapy. Add in additional costs: PT, MRI's of brain and spine (he has 4 lesions on his spine), and what not.

 

What happens in the future?

 

Kris

 

Actually, if he is a biological child of an AD service member, I don't believe he can be dropped before age 21.  When I married an AD servicemember (prior to Tricare being around), they actually backdated my two kids (from a previous marriage) to the date my husband joined the military.  In DEERS STILL, my kids show eligibility date from the date he joined, my date shows from our date of marriage.  

 

Not sure how it works once he's 21 (if he can be dropped) if he's in full time school (normally covered to age 23 if in full time).  Once he isn't in school full time, whether at 21 or 23, he can be part of Tricare Young Adult, WITHOUT the servicemember's permission.  Premium for my son in Colorado a year ago was about $165/mo for TYA.

[creekland]

But this isn't solely about someone going without. This is about the next step as well. This is about how we live our lives. Anyone who lives their life with no health insurance is taking a huge risk, but so are the people who rely on their current health insurance plan, that includes cost share programs like Sam.

 

What happens if/when the Impossible or Improbable happens?

What happens if you run out of money?

What happens if you are unable to make your insurance payments?

 

The Impossible happened to my family. Last year, my 17yo son was dx'ed with a very rare form of MS. The CDC lists it at 3 in 1,000,000 and only 10% of those individuals are dx'ed under the age of 20. His current health insurance is through his father, who is AD Navy. However, his dad can drop him at any time. I cannot provide him with health insurance right now, as I'm a full-time student. 

 

He must have insurance. His medications and vitamins cost OOP $65 per month, plus his DMT MS drug is $2100 per month pre-insurance. That is just maintenance. Any relapse and we are talking at minimum several thousand for in-home steroid therapy. Add in additional costs: PT, MRI's of brain and spine (he has 4 lesions on his spine), and what not.

 

What happens in the future?

 

Kris

 

I've already said I'd vote for a single payer system over what the US has currently (or in the past).  My musings have just been for a better way for all.  My step-mom is Canadian (NS).  My mom and dad (and aunts/uncles) have medicare.  My uncle is a veteran.  Our exchange student was/is German.  I've seen all the above (pros/cons) IRL and consider health share (with modifications to cover all as already mentioned) to be superior to any of those, but any of those are superior to the cruddy "system" we have now.